NMC CBT Sample Questions and CBT Exam Practice 6

Disclaimer: Note that these questions are just sample questions to help you to pass the NMC CBT exam. They were sent in by a reader

1. Nurses who seek to enhance their cultural-competency skills and apply sensitivity toward others are committed to which professional nursing value?
A. Autonomy
B. Strong commitment to service
C. Belief in the dignity and worth of each person
D. Commitment to education

2. When trying to make a responsible ethical decision, what should the nurse understand as the basis for ethical reasoning?
A. Ethical principles & code
B. The nurse’s experience
C. The nurse’s emotional feelings
D. The policies & practices of the institution

3. A fully alert & competent 89 year old client is in end stage liver disease. The client says , “I’m ready to die,” & refuses to take food or fluids . The family urges the client to allow the nurse to insert a feeding tube. What is the nurse’s moral responsibility?
A. The nurse should obtain an order for a feeding tube
B. The nurse should encourage the client to reconsider the decision
C. The nurse should honor client’s decision
D. The nurse must consider that the hospital can be sued if she honors the client’s request

4. A mentally competent client with end stage liver disease continues to consume alcohol after being informed of the consequences of this action. What action best illustrates the nurse’s role as a client advocate?
A. Asking the spouse to take all the alcohol out of the house
B. Accepting the patient’s choice & not intervening
C. Reminding the client that the action may be an end-of life decision
D. Refusing to care for the client because of the client’s noncompliance

5. A nurse demonstrates patient advocacy by becoming involved in which of the following activities?
A. Taking a public stand on quality issues and educating the public on “public interest” issues
B. Teaching in a school of nursing to help decrease the nursing shortage
C. Engaging in nursing research to justify nursing care delivery
D. Supporting the status quo when changes are pending

6. The nurse is functioning as a patient advocate. Which of the following would be the first step the nurse should take when functioning in this role?
A. Ensure that the nursing process is complete and includes active participation by the patient and family
B. Become creative in meeting patient needs.
C.Empower the patient by providing needed information and support
D.Help the patient understand the need for preventive health care.

7. A famous actress has had plastic surgery. The media contacts the nurse on the unit and asks for information about the surgery. The nurse knows:
A. Any information released will bring publicity to the hospital.
B. Nurses are obligated to respect client’s privacy and confidentiality.
C. It does not matter what is disclosed, the media will find out any way.
D. According to beneficence, the nurse has an obligation to implement actions that will benefit clients.

8. Essence of Care benchmarking is a process of ——-?

A. Comparing, sharing anddeveloping practice in order to achieve and sustain best practice.

B. Assess clinical area against best practice

C. Review achievement towards best practice

D. Consultation and patient involvement

9. An adult is offered the opportunity to participate in research on a new therapy. The researcher asks the nurse to obtain the patient’s consent. What is most appropriate for the nurse to take?
A. Be sure the patient understands the project before signing the consent form
B. Read the consent form to the patient & give him or her an opportunity to ask questions
C. Refuse to be the one to obtain the patient’s consent
D. Give the form to the patient & tell him or her to read it carefully before signing it

10. An adult has just returned to the unit from surgery. The nurse transferred him to his bed but did not put up the side rails. The client fell and was injured. What kind of liability does the nurse have?
A. None
B. Negligence
C. Intentional tort
D. Assault & battery

11. A patient is admitted to the ward with symptoms of acute diarrhea. What should your initial management be?
A. Assessment, protective isolation , universal precautions
B. Assessment , source isolation , antibiotic therapy
C. Assessment , protective isolation , antimotility medication
D. Assessment , source isolation , universal precautions

12. Your patient has undergone a formation of a loop colostomy. What important considerations should be borne in mind when selecting an appropriate stoma appliance for your patient?
A. Dexterity of the patient, consistency of effluent , type of stoma
B. Patient preference , type of stoma , consistence of effluent , state of peristomal skin, dexterity of patient
C. Patient preference , lifestyle , position of stoma , consistency of effluent , state of peristomal skin , dexterity of patient , type of stoma
D. Cognitive ability, lifestyle, patient dexterity, position of stoma, state of peristomal skin, type of stoma, consistency of effluent, patient preference.

13. What are the principles of gaining informed consent prior to plan surgery?
A. Gaining permission for an imminent procedure by providing information in medical terms, ensuring a patient knows the potential risks and intended benefits
B. Gaining permission from a patient who is competent to give it, by providing information, both verbally and with written material, relating to the planned procedure, for them to read on the day of planned surgery
C. Gaining permission from a patient who is competent to give it, by informing them about the procedure and highlighting risks if the procedure is not carried out
D. Gaining permission from a patient who is competent to give it, by providing information in understandable terms prior to surgery, allowing timefor answering questions, and inviting voluntary participation

14. When should adult patients in acute hospital settings have observations taken?
A. 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
B. When they are admitted & then once daily unless they deteriorate
C. As indicated by the doctor
D. Temperature should be taken daily , respirations at night , pulse & blood pressure 4 hourly

15. A patient is agitated and is unable to settle, she is also finding it difficult to sleep, reporting that she is in pain. What would you do at this point?

A. Ask her to score her pain, describe its intensity, duration, describe its intensity, duration, the site, any relieving measures and what makes it worse, looking for non-verbal clues, so you can determine the appropriate method of pain management
B. Give her some sedatives so she goes to sleep
C. Calculate a pain score, suggest that she takes deep breaths, reposition her pillows, return in 5min to gain a comparative pain score
D. Give her any analgesia she is due. If she has not any, contact the doctor to get some prescribed. Also give her a warm milky drink and reposition her pillows. Document your action

16. A patient in your care knocks their head on the bedside locker when reaching down to pick up something they have dropped. What do you do?
A. Let the patient’s relatives know so that they don’t make a complaint & write an incident report for yourself so you remember the details in case there are problems in the future
B. Help the patient to a safe comfortable position, commence neurological observations & ask the patient’s doctor to come & review them, checking the injury isn’t serious. when this has taken place , write up what happened & any future care in the nursing notes
C. Discuss the incident with the nurse in charge , & contact your union representative in case you get into trouble
D. Help the patient to a safe comfortable position, take a set of observations & report the incident to the nurse in charge who may call a doctor. Complete an incident form. At an appropriate time , discuss the incident with the patient & if they wish , their relatives

17. Which of the following client should the nurse deal with first
A. A client who needs her dressing changed
B. A client who needs to be suctioned
C. A client who needs to be medicated for incisional pain
D. A client who is incontinent & needs to be cleaned

18. A client on your medical surgical unit has a cousin who is a physician & wants to see the chart. which of the following is the best response for the nurse to take
A. Hand the cousin the client chart to review
B. Ask the client to sign an authorization & have someone review the chart with cousin
C. Call the attending physician & have the doctor speak with the cousin
D. Tell the cousin that the request cannot be granted
19. Which professional organizations are responsible for establishing the code?
A. NHS
B. NMC
C. American Nurses Association, National League of Nursing, and American Association of Nurse Executives
D. State Boards of Nursing, state and national organizations, and specialty organizations

20. The code is concerned about focusing on which of the following criteria
A – Clinical expertise
B – Conduct, behavior, ethics & professionalism
C – Hospital policies
D – Disciplinary actions

Topic 2 – communication & interpersonal skills
21. What factors are essential in demonstrating supportive communication to patients?
A. Listening , clarifying the concerns & feelings of the patient using open questions
B. Listening , clarifying the physical needs of the patient using open questions
C. Listening , clarifying the physical needs of the patient using open questions
D. Listening , reflecting back the patient’s concerns & providing a solution
22. Which behaviors will encourage a patient to talk about their concerns?
A. Giving reassurance & telling them not to worry
B. Asking the patient about their family & friends
C. Tell the patient you are interested in what is concerning them & that you are available to listen
D. Tell the patient you are interested in what is concerning them if they tell you , they will feel better
23. What is the difference between denial & collusion?
A. Denial is when a healthcare professional refuses to tell a patient their diagnosis for the protection of the patient whereas collusion is when healthcare professionals & the patient agree on the information to be told to relatives & friends
B. Denial is when a patient refuses treatment & collusion is when a patient agrees to it
C. Denial is a coping mechanism used by an individual with the intention of protecting themselves from painful or distressing information whereas collusion is the withholding of information from the patient with the intention of ‘protecting them’
D. Denial is a normal acceptable response by a patient to a life-threatening diagnosis whereas collusion is not
24. If you were explaining anxiety to a patient, what would be the main points to include?
A. Signs of anxiety include behaviours such as muscle tension. palpitations ,a dry mouth , fast shallow breathing , dizziness & an increased need to urinate or defaecate
B. Anxiety has three aspects : physical – bodily sensations related to flight & fight response , behavioural – such as avoiding the situation , & cognitive ( thinking ) – such as imagining the worst
C. Anxiety is all in the mind , if they learn to think differently , it will go away
D. Anxiety has three aspects: physical – such as running away , behavioural – such as imagining the worse ( catastrophizing) , & cognitive ( thinking) – such as needing to urinate.
25. What are the principles of communicating with a patient with delirium?
A. Use short statements & closed questions in a well –lit, quiet , familiar environment
B. Use short statements & open questions ina well lit, quiet , familiar environment
C. Write down all questions for the patient to refer back to
D. Communicate only through the family using short statements & closed questions

26. Which of the following statements by a nurse would indicate an understanding of intrapersonal communications?
A. “Intrapersonal communications occur between two or more people.”
B. “Intrapersonal communications occurs within a person”
C. “Interpersonal communications is the same as intrapersonal communications.”
D. “Nurses should avoid using intrapersonal communications.”

27. Which therapeutic communication technique is being used in this nurse-client interaction?
Client: “When I get angry, I get into a fistfight with my wife or I take it out on the kids.”
Nurse: “I notice that you are smiling as you talk about this physical violence.”
A. Encouraging comparison
B. Exploring
C. Formulating a plan of action
D. Making observations

28. Which nursing statement is a good example of the therapeutic communication technique of giving recognition?

A. “You did not attend group today. Can we talk about that?”
B. “I’ll sit with you until it is time for your family session.”
C. “I notice you are wearing a new dress and you have washed your hair.”
D. “I’m happy that you are now taking your medications. They will really help.”

29. The nurse asks a newly admitted client, “What can we do to help you?” What is the purpose of this therapeutic communication technique?

A. To reframe the client’s thoughts about mental health treatment
B. To put the client at ease
C.To explore a subject, idea, experience, or relationship
D.To communicate that the nurse is listening to the conversation

30. Which nursing statement is a good example of the therapeutic communication technique of focusing?

A. “Describe one of the best things that happened to you this week.”
B. “I’m having a difficult time understanding what you mean.”
C. “Your counseling session is in 30 minutes. I’ll stay with you until then.”
D. “You mentioned your relationship with your father. Let’s discuss that further.”

31. Which nursing response is an example of the nontherapeutic communication block of requesting an explanation?

A. “Can you tell me why you said that?”
B. “Keep your chin up. I’ll explain the procedure to you.”
C. “There is always an explanation for both good and bad behaviors.”
D. “Are you not understanding the explanation I provided?”

32. Which therapeutic communication technique should the nurse use when communicating with a client who is experiencing auditory hallucinations?

A. “My sister has the same diagnosis as you and she also hears voices.”
B. “I understand that the voices seem real to you, but I do not hear any voices.”
C. “Why not turn up the radio so that the voices are muted.”
D. “I wouldn’t worry about these voices. The medication will make them disappear.”

33. Which nursing statement is a good example of the therapeutic communication technique of offering self?

A. “I think it would be great if you talked about that problem during our next group session.”
B. “Would you like me to accompany you to your electroconvulsive therapy treatment?”
C. “I notice that you are offering help to other peers in the milieu.”
D. “After discharge, would you like to meet me for lunch to review your outpatient progress?”

34. On a psychiatric unit, the preferred milieu environment is BEST described as:
A. Providing an environment that is safe for the patient to express feelings.
B. Fostering a sense of well-being and independence in the patient.
C. Providing an environment that will support the patient in his or her therapeutic needs.
D. Fostering a therapeutic social, cultural, and physical environment.
35. A new mother is admitted to the acute psychiatric unit with severe postpartum depression. She is tearful and states, “I don’t know why this happened to me! I was so excited for my baby to come, but now I don’t know!” Which of the following responses by the nurse is MOST therapeutic?
A. “Having a new baby is stressful, and the tiredness and different hormone levels don’t help. It happens to many new mothers and is very treatable.”
B. “Maybe you weren’t ready for a child after all.”
C. “What happened once you brought the baby home? Did you feel nervous?”
D. “Has your husband been helping you with the housework at all?”

36. A patient with antisocial personality disorder enters the private meeting room of a nursing unit as a nurse is meeting with a different patient. Which of the following statements by the nurse is BEST?
A. “I’m sorry, but HIPPA says that you can’t be here. Do you mind leaving?”
B. “You may sit with us as long as you are quiet.”
C. “I need you to leave us alone.”
D. “Please leave and I will speak with you when I am done.”

37. The wife of a client with PTSD (post traumatic stress disorder) communicates to the nurse that she is having trouble dealing with her husband’s condition at home. Which of the following suggestions made by the nurse is CORRECT?
A. “Discourage your husband from exercising, as this will worsen his condition.”
B. “Encourage your husband to avoid regular contact with outside family members.”
C. “Do not touch or speak to your husband during an active flashback. Wait until it is finished to give him support.”
D. “Keep your cupboards free of high-sugar and high-fat foods.”
38. A patient has just been told by the physician that she has stage III uterine cancer. The patient says to the nurse, “I don’t know what to do. How do I tell my husband?” and begins to cry. Which of the following responses by the nurse is the MOST therapeutic?
A. “It seems to be that this is a lot to handle. I’ll stay here with you.”
B. “How do you think would be best to tell your husband?”
C. “I think this will all be easier to deal with than you think.”
D. “Why do you think this is happening to you?”

39. A client expressed concern regarding the confidentiality of her medical information. The nurse assures the client that the nurse maintains client confidentiality by:
A. Sharing the information with all members of the health care team.
B. Limiting discussion about clients to the group room and hallways.
C. Summarizing the information the client provides during assessments and documenting this summary in the chart.
D. Explaining the exact limits of confidentiality in the exchanges between the client and the nurse.

40. When caring for clients with psychiatric diagnoses, the nurse recalls that the purpose of psychiatric diagnoses or psychiatric labeling is to:
A. Identify those individuals in need of more specialized care.
B. Identify those individuals who are at risk for harming others.
C. Enable the client’s treatment team to plan appropriate and comprehensive care.
D. Define the nursing care for individuals with similar diagnoses.

Topic 3 – Nursing Practice & Decision Making
41. If you were told by a nurse at handover to take “standard precautions” what would you expect to be doing?
A. Taking precautions when handling blood & ‘high risk’ body fluids sp that you don’t pass on any infection to the patient.
B. Wearing gloves, aprons & mask when caring for someone in protective isolation to protect yourself from infection
C. Asking relatives to wash their hands when visiting patients in the clinical setting
D. Using appropriate hand hygiene , wearing gloves & aprons when necessary ,disposing of used sharp instruments safely & providing care in a suitably clean environment to protect yourself & the patients
42. You are told a patient is in ‘source isolation’. What would you do & why?
A. Isolating a patient so that they don’t catch any infections
B. Nursing an individual who is regarded as being particularly vulnerable to infection in such a way as to minimize the transmission of potential pathogens to that person
C. Nurse the patient in isolation , ensure that you wear appropriate personal protective equipment (PPE) & adhere to strict hand hygiene , for the purpose of preventing the spread of organisms from that patient to others
D. Nursing a patient who is carrying an infectious agent that may be risk to others in such a way as to minimize the risk of the infection spreading elsewhere in their body
43. What would make you suspect that a patient in your care had a urinary tract infection?
A. The doctor has requested a midstream urine specimen
B. The patient has a urinary catheter in situ & the patient’s wife states that he seems more forgetful than usual
C. The patient has spiked a temperature , has a raised white cell count (WCC) , has new –onset confusion & the urine in the catheter bag is cloudy
D. The patient has complained of frequency of faecal elimination & hasn’t been drinking enough
44. You are caring for a patient in isolation with suspected clostridium difficile. What are the essential key actions to prevent the spread of infection?
A. Regular hand hygiene & the promotion of the infection prevention link nurse role
B. Encourage the doctors to wear gloves & aprons, to be bare below the elbow & to wash hands with alcohol handrub . ask for cleaning to be increased with soap-based products
C. Ask the infection prevention team to review the patient’s medication chart & provide regular teaching sessions on the ‘5 moments of hand hygiene ‘. Provide the patient & family with adequate information
D. Review antimicrobials daily, wash hands with soap & water before & after each contact with the patient , ask for enhanced cleaning with chlorine –based products & use gloves & aprons when disposing of body fluids
45. What steps would you take if you had sustained a needlestick injury?
A. Ask for advice from the emergency department, report to occupational health & fill in an incident form.
B. Gently make the wound bleed, place under running water & wash thoroughly with soap & water. Complete an incident form & inform your manager. Co-operate with any action to test yourself or the patient for infection with a bloodborne virus but do not obtain blood or consent for testing from the patient yourself; this should be done by someone not involved in the incident.
C. Take blood from patient & self for Hep B screening & take samples & form to bacteriology. Call your union representative for support. Make an appointment with your GP for a sickness certificate to take time off until the wound site has healed so you contaminate any other patients.
D. Wash the wound with soap & water. Cover any wound with a waterproof dressing to prevent entry of any other foreign material. Wear gloves while working until the wound has healed to prevent contaminating any other patients. Take any steps to have the patient or yourself tested for the presence of a bloodborne virus.

46. What functions should a dressing fulfill for effective wound healing?
A. High humidity, insulation, gaseous exchange, absorbent
B. Anaerobic, impermeable, conformable, low humidity
C. Insulation, low humidity, sterile, high adherence
D. Absorbent, low adherence, anaerobic, high humidity

47. When would it be beneficial to use a wound care plan?
A. On all chronic wound
B. On all infected wounds
C. On all complex wounds
D. On every wound

48. How would you care for a patient with necrotic wound?
A. Systemic antibiotic therapy and apply a dry dressing
B. Debride and apply a hydrogel dressing
C. Debride and apply an antimicrobial dressing
D. Apply a negative pressure dressing

49. A new postsurgical wound is assessed by the nurse and is found to be hot, tender and swollen. How could this wound be best described?
A. In the inflammation phase of healing
B. In the haemostasis phase of haling
C. In the reconstructive phase of wound healing
D. As an infected wound

50. What are the four stages of wound healing in the order they take place?
A. Proliferative phase, inflammatory phase, remodeling phase, maturation phase
B. Haemostasis, inflammation phase, proliferative phase, maturation phase
C. Inflammatory phase, dynamic stage, neutrophil phase, maturation phase
D. Haemostasis, proliferation phase, inflammation phase, remodeling phase
E. Haemostasis, proliferation phase, inflammation phase, remodeling phase

51. If an elderly immobile patient had a “grade 3 pressure sore”, what would be your management?
A. Hydrocolloid dressing, pressure- relieving mattress, nutritional support
B. Dry dressing, pressure relieving mattress, mobilization
C. Film dressing, mobilization. Positioning, nutritional support
D. Foam dressing, pressure relieving mattress, nutritional support

52. How can risks be reduced in the healthcare setting?
A. By adopting a culture of openness & transparency & exploring the root causes of patient safety incidents.
B. Healthcare will always involve risks so incidents will always occur .we need to accept this
C. Healthcare professionals should be encouraged to fill in incident forms ; this will create a culture of “no blame”
D. By setting targets which measure quality

53. A patient in your care knocks their head on the bedside locker when reaching down to pick up something they have dropped. What do you do?
A. Let the patient’s relatives know so that they don’t make a complaint & write an incident report for yourself so you remember the details in case there are problems in the future
B. Help the patient to a safe comfortable position, commence neurological observations & ask the patient’s doctor to come & review them, checking the injury isn’t serious. when this has taken place , write up what happened & any future care in the nursing notes
C. Discuss the incident with the nurse in charge , & contact your union representative in case you get into trouble
D. Help the patient to a safe comfortable position, take a set of observations & report the incident to the nurse in charge who may call a doctor. Complete an incident form. At an appropriate time , discuss the incident with the patient & if they wish , their relatives

54. You are looking after a 75 year old woman who had an abdominal hysterectomy 2 days ago. What would you do reduce the risk of her developing a deep vein thrombosis (DVT)?
A. Give regular analgesia to ensure she has adequate pain relief so she can mobilize as soon as possible. Advise her not to cross her legs
B. Make sure that she is fitted with properly fitting antiembolic stockings & that are removed daily
C. Ensure that she is wearing antiembolic stockings & that she is prescribed prophylactic anticoagulation & is doing hourly limb exercises
D. Give adequate analgesia so she can mobilize to the chair with assistance, give subcutaneous low molecular weight heparin as prescribed. Make sure that she is wearing antiembolic stockings

55. You are looking after an emaciated 80-year old man who has been admitted to your ward with acute exacerbation of chronic obstructive airways disease (COPD). He is currently so short of breath that it is difficult for him to mobilize. What are some of the actions you take to prevent him developing a pressure ulcer?
A. He will be at high risk of developing a pressure ulcer so place him on a pressure relieving mattress
B. Assess his risk of developing a pressure ulcer with a risk assessment tool. If indicated, procure an appropriate pressure –relieving mattress for his bed & cushion for his chair. Reassess the patient’s pressure areas at least twice a day & keep them clean & dry. Review his fluid & nutritional intake & support him to make changes as indicated.
C. Assess his risk of developing a pressure ulcer with a risk assessment tool & reassess every week. Reduce his fluid intake to avoid him becoming incontinent & the pressure areas becoming damp with urine
D. He is at high risk of developing a pressure ulcer because of his recent acute illness, poor nutritional intake & reduced mobility. By giving him his prescribed antibiotic therapy, referring him to the dietician & physiotherapist, the risk will be reduced.

56. You are looking after a 76-year old woman who has had a number of recent falls at home. What would you do to try & ensure her safety whilst she is in hospital?
A. Refer her to the physiotherapist & provide her with lots of reassurance as she has lost a lot of confidence recently
B. Make sure that the bed area is free of clutter. Place the patient in a bed near the nurse’s station so that you can keep an eye on her. Put her on an hourly toileting chart. obtain lying & standing blood pressures as postural hypotension may be contributing to her falls
C. Make sure that the bed area is free of clutter & that the patient can reach everything she needs, including the call bell. Check regularly to see if the patient needs assistance mobilizing to the toilet. ensure that she has properly fitting slippers & appropriate walking aids
D. Refer her to the community falls team who will asses her when she gets home
57. The client reports nausea and constipation. Which of the following would be the priority nursing action?

A. Collect a stool sample
B. Complete an abdominal assessment
C. Administer an anti-nausea medication
D. Notify the physician

58. The nurse suspects that a client is withholding health-related information out of fear of discovery and possible legal problems. The nurse formulates nursing diagnoses for the client carefully, being concerned about a diagnostic error resulting from which of the following?

A. Incomplete data
B. Generalize from experience
C. Identifying with the client
D. Lack of clinical experience

59. Which of the following descriptors is most appropriate to use when stating the “problem” part of a nursing diagnosis?

A. Grimacing
B. Anxiety
C. Oxygenation saturation 93%
D. Output 500 mL in 8 hours

60. The rehabilitation nurse wishes to make the following entry into a client’s plan of care: “Client will reestablish a pattern of daily bowel movements without straining within two months.” The nurse would write this statement under which section of the plan of care?

A. Nursing diagnosis/problem list
B. Nursing orders
C. Short-term goals
D. Long-term goals

Topic 4- Leadership, Management & Team working
61. The nurse has just been promoted to unit manager. Which advice, offered by a senior unit manager, will help this nurse become inspirational and motivational in this new role?
A. “If you make a mistake with your staff, admit it, apologize, and correct the error if possible.”
B. “Don’t be too soft on the staff. If they make a mistake, be certain to reprimand them immediately.”
C. “Give your best nurses extra attention and rewards for their help.”
D. “Never gets into a disagreement with a staff member.

62. The famous 14 Principles of Management was first defined by
A. Elton Mayo
B. Henri Fayol
C. Adam smith
D. James Watt
63. The nursing staff communicates that the new manager has a focus on the “bottom line,” and little concern for the quality of care. What is likely true of this nurse manager?
A. The manager is looking at the total care picture.
B. The manager is communicating the importance of a caring environment.
C. The manager understands the organization’s values and how they mesh with the manager’s values.
D. The manager is unwilling to listen to staff concerns unless they have an impact on costs.

64. A very young nurse has been promoted to nurse manager of an inpatient surgical unit. The nurse is concerned that older nurses may not respect the manager’s authority because of the age difference. How can this nurse manager best exercise authority?
A. Use critical thinking to solve problems on the unit.
B. Give assignments clearly, taking staff expertise into consideration.
C. Understand complex health care environments.
D. Maintain an autocratic approach to influence results.

65. What statement, made in the morning shift report, would help an effective manager develop trust on the nursing unit?
A. “I know I told you that you could have the weekend off, but I really need you to work.”
B. “The others work many extra shifts, why can’t you?”
C. “I’m sorry, but I do not have a nurse to spare today to help on your unit. I cannot make a change now, but we should talk further about schedules and needs.”
D. “I can’t believe you need help with such a simple task. Didn’t you learn that in school?”

66. The nurse executive of a health care organization wishes to prepare and develop nurse managers for several new units that the organization will open next year. What should be the primary goal for this work?
A. Focus on rewarding current staff for doing a good job with their assigned tasks by selecting them for promotion.
B. Prepare these managers so that they will focus on maintaining standards of care.
C. Prepare these managers to oversee the entire health care organization.
D. Prepare these managers to interact with hospital administration.

67. What are the key competencies and features for effective collaboration?
A. Effective communication skills, mutual respect, constructive feedback, and conflict management.
B. High level of trust and honesty, giving and receiving feedback, and decision making.
C. Mutual respect and open communication, critical feedback, cooperation, and willingness to share ideas and decisions.
D. Effective communication, cooperation, and decreased competition for scarce resources.

68. A registered nurse is a preceptor for a new nursing graduate an is describing critical paths and variance analysis to the new nursing graduate. The registered nurse instructs the new nursing graduate that a variance analysis is performed on all clients:

a) continuously
b) daily during hospitalization
c) every third day of hospitalization
d) every other day of hospitalization

69. A nurse manager is planning to implement a change in the method of the documentation system for the nursing unit. Many problems have occurred as a result of the present documentation system, and the nurse manager determines that a change is required. The initial step in the process of change for the nurse manager is which of the following?

a) plan strategies to implement the change
b) set goals and priorities regarding the change process
c) identify the inefficiency that needs improvement or correction
d) identify potential solutions and strategies for the change process

70. Ms. Castro is newly-promoted to a patient care manager position. She updates her knowledge on the theories in management and leadership in order to become effective in her new role. She learns that some managers have low concern for services and high concern for staff. Which style of management refers to this?

a.Organization Man
b. Impoverished Management
c. Country Club Management
d. Team Management

71. What are essential competencies for today’s nurse manager?
A. A vision and goals
B. Communication and teamwork
C. Self- and group awareness
D. Strategic planning and design

72. As a nurse manager achieves a higher management position in the organization, there is a need for what type of skills?
A. Personal and communication skills
B. Communication and technical skills
C. Conceptual and interpersonal skills
D. Visionary and interpersonal skills

73. The characteristics of an effective leader include:
A. attention to detail
B. financial motivation
C. sound problem-solving skills and strong people skills
D. emphasis on consistent job performance

74. What is the most important issue confronting nurse managers using situational leadership?
A. Leaders can choose one of the four leadership styles when faced with a new situation.
B. Personality traits and leader’s power base influence the leader’s choice of style.
C. Value is placed on the accomplishment of tasks and on interpersonal relationships between leader and group members and among group members.
D. Leadership style differs for a group whose members are at different levels of maturity.

75. A nurse case manager receives a referral to provide case management services for an adolescent mother who was recently diagnosed with HIV. Which statement indicates that the patient understands her illness?

A. “I can never have sex again, so I guess I will always be a single parent.”
B. “I will wear gloves when I’m caring for my baby, because I could infect my baby with AIDS.”
C. “My CD4 count is 200 and my T cells are less than 14%. I need to stay at these levels by eating and sleeping well and staying healthy.”
D. “My CD4 count is 800 and my T cells are greater than 14%. I need to stay at these levels by eating and sleeping well and staying healthy.”

76. When developing a program offering for patients who are newly diagnosed with diabetes, a nurse case manager demonstrates an understanding of learning styles by:
A. Administering a pre- and posttest assessment.
B. Allowing patient’s time to voice their opinions.
C. Providing a snack with a low glycemic index.
D. Utilizing a variety of educational materials.

77. There have been several patient complaints that the staff members of the unit are disorganized and that “no one seems to know what to do or when to do it.” The staff members concur that they don’t have a real sense of direction and guidance from their leader. Which type of leadership is this unit experiencing?
1. Autocratic.
2. Bureaucratic.
3. Laissez-faire.
4. Authoritarian.

78. Which strategy could the nurse use to avoid disparity in health care delivery?
A. Recognize the cultural issue related to patient care.
B. Request more health plan options.
C. Care for more patients even if quality suffers.
D. Campaign for fixed nurse-patient ratios.

79. Which option best illustrates a positive outcome for managed care?
A. Reshaping current policy.
B. Involvement in the political process.
C. Increase in preventative services.
D. Cost-benefit analysis.

80. The patient is being discharged from the hospital after having a coronary artery bypass graft (CABG). Which level of the health care system will best serve the needs of this patient at this point?
1. Primary care.
2. Secondary care.
3. Tertiary care.
4. Public health care.

Topic 5- Adult Nursing
81. 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”

A. The fluid output has exceeded the input
B. The doctor may consider increasing the IV drip rate
C. The fluid balance chart can be stopped as “positive” means “good”
D. The fluid input has exceeded the output

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

A. Blood glucose levels, full blood count, stoma site and body weight
B. Eye sight, hearing, full blood count, lung function and stoma site
C. Assess swallowing, patient choice, fluid balance, capillary refill time
D. Daily urinalysis, ECG, Protein levels and arterial pressure

83. A patient needs weighing, as he is due a drug that is calculated on bodyweight. He experiences a lot of pain on movement so is reluctant to move, particularly stand up. What would you do?
A. Document clearly in the patient’s notes that a weight cannot be obtained
B. Offer the patient pain relief and either use bed scales or a hoist with scales built in
C. Discuss the case with your colleagues and agree to guess his body weight until he agrees to stand and use the chair scales
D. Omit the drugs as it is not safe to give it without this information; inform the doctor and document your actions

84. If the prescribed volume is taken, which of the following types of feed will provide all protein, vitamins, minerals and trace elements to meet patient’s nutritional requirements?
A. Protein shakes/supplements
B. Sip feeds
C. Energy drink
D. Mixed fat and glucose polymer solutions/powder

85. 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?

A. The feed
B. An infection
C. Food poisoning
D. Being in hospital

86. Your patient has a bulky oesophageal tumor and is waiting for surgery. 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?
A. Nasogastric tube feeding
B. Feeding via a Percutaneous Endoscopic Gastrostomy(PEG)
C. Feeding via a Radiologically Inserted Gastostomy(RIG)
D. Continue oral

87. What is the best way to prevent who is receiving an enteral feed from aspirating?
A. Lie them flat
B. Sit them at least 45 degree angle
C. Tell them to lie in their side
D. Check their oxygen saturations
88. Which of the following medications are safe to be administered via a naso-gastric tube?
A. Enteric- coated drugs to minimize the impact of gastric irritation
B. A cocktail of all medications mixed together, to save time and prevent fluid over loading the patient
C. Any drugs that can be crushed
D. Drugs that can be absorbed via this route, can be crushed and given diluted or dissolved in 10-15ml of water

89. Which check do you need to carry out before setting up an enteral feed via nasogastric tube?
A. That when flushed with red juice, the red juice can be seen when the tube is aspirated
B. That air cannot be heard rushing into the lungs by doing the WHOOSH TEST
C. 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.
D. 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.

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

A. Temperature and Pulse before the blood transfusion begins, then every hour, and at the end of bag/unit
B. 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.
C. Temperature, pulse, blood pressure and respiration and urinalysis before the blood transfusion, then at end of bag.
D. Pulse, blood pressure and respiration every hour, and at the end of the bag

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

A. 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.
B. The muscles provide a structural framework and are moved by bones to which they are attached by ligaments
C. The skeleton provides a structural framework; this is moved by ligaments that stretch and contract.
D. The muscles provide a structural framework, moving by contracting or extending, crossing at least one joint and attached to the articulating bones

92. What are the most common effects of inactivity?
A. Pulmonary embolism, UTI, & fear of people
B. Deep arterial thrombosis, respiratory infection, fears of movement, loss of consciousness, de-conditioning of cardiovascular system leading to an increased risk of angina.
C. Loss of weight, frustration and deep vein thrombosis
D. Social isolation, loss of independence, exacerbation of symptoms, rapid loss of strength in leg muscles, de-conditioning of cardiovascular system leading to an increased risk of chest infection and pulmonary embolism.

93. What do you need to consider when helping a patient with shortness of breath sit out in a chair?
A. 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
B. Sitting in a 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
C. The patient 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.
D. 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 below20 degree Celsius

94. Your patient has bronchitis and has difficulty in clearing his chest. What position would help to maximize the drainage of secretions?
A. Lying flat on his back while using a nebulizer
B. Sitting up leaning on pillows and inhaling humidified oxygen
C. Lying on his side with the area to be drained uppermost after the patient has had humidified air
D. Standing up in fresh air taking deep breaths

95. 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?
A. Give Mrs. Jones analgesia and suggest she sleeps in chair
B. Try to diminish increased tone by avoiding extra stimulation by ensuring her foot does not come into contact with the end of the bed; supporting with a pillow, her left leg in side lying and keeping the knee flexed
C. Give Mrs. Jone diazepam and tilt the bed
D. Suggest a warm bath before she lies on the bed. Then use pillows to support the stiff limb

96. When should adult patients in acute hospital settings have observations taken?
E. 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
F. When they are admitted & then once daily unless they deteriorate
G. As indicated by the doctor
H. Temperature should be taken daily , respirations at night , pulse & blood pressure 4 hourly

97. Why are physiological scoring systems or early warning scoring systems used in clinical practice?
A. They help the nursing staff to accurately predict patient dependency on a shift by shift basis
B. The system provides an early accurate predictor of deterioration by identifying physiological criteria that alert the nursing staff to a patient at risk
C. These scoring systems are carried out as part of a national audit so we know how sick patients are in the united Kingdom
D. They enable nurses to call for assistance from the outreach team or the doctors via an electronic communication system

98. Why would the intravenous route be used for the administration of medications?
A. It is a useful form of medication for patients who refuse to take tablets because they don’t want to comply with treatment
B. It is cost effective because there is less waste as patients forget to take oral medication
C. The intravenous route reduces the risk of infection because the drugs are made in a sterile environment & kept in aseptic conditions
D. The intravenous route provides an immediate therapeutic effect & gives better control of the rate of administration as a more precise dose can be calculated so treatment can be more reliable

99. You have been asked to give Mrs. Patel her Mid-day oral metronidazole. You have never met her before. What do you need to check on the drug chart before you administer it?
A. Her name & address, the date of the prescription & dose
B. Her name, date of birth , the ward, consultant , the dose & route, & that it is due at 12.00
C. Her name, date of birth, hospital number, if she has any known allergies, the prescription for metronidazole: dose, route, time, date & that it is signed by the doctor, & when it was last given.
D. Her name & address, date of birth, name of ward & consultant, if she has any known allergies specifically to penicillin that prescription is for metronidazole; dose, route, time, date & that it is signed by the doctor, when it was last given & who gave it so you can check with them how she reached.

100. As a newly qualified nurse, what would you do if a patient vomits when taking or immediately after taking tablets?
A. Comfort the patient, check to see if they have vomited the tablets, & ask the doctor to prescribe something different as these obviously don’t agree with the patient
B. Check to see if the patient has vomited the tablets & if so, document this on the prescription chart. If possible, the drugs may be given again after the administration of antiemetics or when the patient no longer feels nauseous. It may be necessary to discuss an alternative route of administration with the doctor
C. In the future administer antiemetics prior to administration of all tablets
D. Discuss with pharmacy the availability of medication ina liquid form or hide the tablets in food to take the taste away.

101 What is the preferred position for Abdominal Paracentesis?
A. Prone
B. Supine with head slightly elevated
C. Supine with knees bent
D. Side-Lying
102 After lumbar puncture, the patient experiences shock. What is the etiology behind it?
A. Increased ICP.
B. Headache.
C. Side effect of medications.
D. CSF leakage

103 Proper technique to use walker?.
A. -move 10 feet,take small steps
B. -move 10feet,take large wide steps
C. -move 12feet
D. -tansform weight to walker and walk
4 .A patient is recovering from surgery has been advanced from a clear liquid 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?
1) Black Tea
2) Gelatin
3) Custard
4) Ice pop
104 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 asks the client to take which essential action during the tubing change?
A. Breathe normally
B. Turn the head to the right
C. Exhale slowly & evenly
D. Take a deep breath, hold it ,& bear down
105 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?
A. Anthropometric measurements
B. Bleeding gums
C. Dry skin
D. Facial rubor
6. A nurse is adviced one hour vital charting of a patient,how frequently it should be recorded?
A. every one hour
B. whenever the vital signs show deviations from normal
C. Every shift
D Every 3 hours

106 You see a man collapsing while you are in a queue. What will you do first as BLS Certified Nurse.
A. Shout for help
B. Check for responsivness
C. Leave the patient
D. Start CPR

107 When a patient arrives to the hospital who speaks a different language. Who is responsible for arranging an interpreter?
A. Doctor
B. Registered Nurse
C. Nursing assistant
D. Management

108 A COPD patient is in home care. When you visit the patient, he is dyspnoeic, anxious and frightened. He is already on 2 lit oxygen with nasal cannula.What will be your action
A. Call the emergency service.
B. GiveOramorph 5mg medications as prescribed.
C. Ask the patient to calm down.
D. Increase the flow of oxygen to 5 L
109: A client breathes shallowly and looks upward when listening to the nurse. Which sensory mode should the nurse plan to use with this client?
1) Auditory
2) Kinesthetic
3) Touch
4) Visual

110: An Eight year old girl with learning disabilities is admitted for a minor surgery, she is very restless and agitated and wants her mother to stay with her, what will you do?
A. Advice the mother to stay till she settles.
b. Act according to company policy
c. Tell her you will take care of the child
d. Inform the Doctor
111 While at outside setup what care will you give as a Nurse if you are exposed to a situation ?
A. Provide care which is at expected level
B. keeping up to professional standards
C. above what is expected
D. Ignoring the situation

112 A newly diagnosed patient with Cancer says “I hate Cancer, why did God give it to me”. Which stage of grief process is this?
A. Denial
B. Anger
C. Bargaining
D. Depression

113 A nurse is adviced one hour vital charting of a patient,how frequently it should be recorded?
A. every one hour
B. whenever the vital signs show deviations from normal
C. Every shift
D Every 3 hours

114 Mrs X 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?
A. Understand her feelings and tell the patient that it is a normal procedure.
B. Tell her that you will arrange a meeting with doctor after the procedure.
C. Give a health eduction on cancer prevention
D. Ignore her question and take her for the procedure.

115. What is the purpose of clinical audit.
• it helps to understand the functioning and effectiveness of nursing activities
• helps to understand the outcomes and processesfor medical and surgical procedures
• helps to identify areas of improvement in the system pertaining to Nursing and medical personnel
• helps to understand medical outcomes and processes only
116 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?
A. Do it
B. Ask your collegue to do it
C. Don’t do it as you are not competent or trained for that & write incident report & inform the supervisor
D. Complain to the supervisor that doctor left you in middle of the procedure.

117 How to act in an emergency in a health care set up?
A. according to our competence
B. according to situation
C. according to instruction
D. acording to the patient’s condition
118 :You are caring for a 17 year old woman who has been admitted with acute exacerbation of asthma. Her peak flow readings are deteriorating and she is becoming wheezy. What would you do?
A. Sit her upright, listen to her chest and refer to the chest physiotherapist.
B. Suggest that the patient takes her Ventolin inhaler and continue to monitor the patient.
C. Undertake a full set of observations to include oxygen saturations and respiratory rate. Administer humidified oxygen, bronchodilators, corticosteroids and antimicrobial therapy as prescribed.
D. Reassure the patient: you know from reading her notes that stress and anxiety often trigger her asthma.
119 If your patient is having positive balance.How will you find out dehydration is balanced.
A. Input exceeds output
B. Output exceeds input
C. Optimally hydrated
D. Optimally dehydrated
120 For which of the following modes of transmission is good hand hygiene a key preventative measure?
A. Airborne
B. Direct contact
C. Indirect contact
D. All of the above

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