New UK NMC Nurse Registration Process For Foreign Nurses

The Nursing and Midwifery Council UK has recently announced it is launching a new faster and easier application process on Monday October 7, 2019, below is everything you need to know about this new process as outlined by UK NMC on her website.

Since the start of 2018 we’ve been working with our partners to review and improve the way we assess professionals with qualifications from outside the EU when they want to come and work in the UK as nurses, midwives and nursing associates.

Our process needs to ensure that the professionals coming onto our register can meet our high standards, but we know that it can be long, costly and complicated.

We’ve made a number of improvements over the last year, such as reducing the cost of our test of competence and changing our English language requirements.

Building on these changes, we’ve developed a new, streamlined overseas registration process.

We launched this for nursing associates in January 2019 and we’re introducing it for nurses and midwives on Monday 7 October 2019.

Why we’re carrying out a review

We want to enable those who meet our requirements to join our register as efficiently as possible.

Unnecessary delay in registration means that applicants can’t practise their chosen profession and this could put them at risk of losing work or, sometimes, having to return home.

We’re making our application process simpler and quicker for candidates by improving our guidance and automating as much of the process as possible.

We’re building on the changes we’ve made so far to introduce an application process that is simpler and quicker for candidates.

We plan to launch a new, streamlined overseas registration process for nurses and midwives on Monday 7 October 2019.

New online application form

We’re moving our online application form into NMC Online to make it more straightforward to apply. Candidates will get their own NMC Online account where they’ll be able to track their application’s progress throughout.

Instead of having to download and post paper forms to us, candidates will be able to complete their application and upload supporting documents online.

We’ll also be able to ask their referees for supporting declarations directly to cut down on having to go back and forth to get things right.

Streamlined requirements

We’ve considered our current registration requirements for nurses and midwives against the evidence we need to allow us to assess each candidate’s ability to practise safely and effectively.

Where we can, we’ve streamlined these requirements while making sure that we still have good levels of assurance over a candidate’s competence.


Our identity requirements provide continued assurance that the person applying to the register is who they say they are.

Candidates under the new process will need to provide:

1. A valid passport
2. A vidence of name changes, if relevant
3.Under the current process candidates are required to provide their birth certificate as well.


Our eligibility criteria under the new process recognises that candidates are trained, qualified professionals.

Candidates under the new process will need to provide a qualification certificate for each part of the register that they are applying for, rather than full transcripts and a form to accompany the transcript of training.

Registration in a candidate’s country of training is no longer a pre-requisite for entry into the UK register. This brings overseas candidates in line with the UK application process.

If they’re registered or have been before, we’ll ask for confirmation from their relevant regulator.

If they haven’t been registered, we’ll ask for confirmation from both their training institute and the relevant regulator that the qualification would lead to registration to the equivalent part of the register they are applying for.

Under the current process candidates are required to provide certification from each country they have been registered.

We‘ve brought the health declaration in line with our revised health and character guidance.

Candidates under the new process will be asked to declare whether they’re capable of safe and effective practice. This might include where they have a health condition and/or disability that is being managed.

If a candidate declares a health condition and/or disability that is being managed, we’ll ask for a supporting declaration from either their medical practitioner or occupational health department.

Under the current process, all candidates are required to provide a good health declaration from their medical practitioner.

Candidates under the new process will be asked to provide a supporting declaration about their character.

If they’re registered or have been in the last three years, we’ll ask for a supporting declaration from their current or most recent regulator.

If they haven’t been registered in the last three years, but have previously held registration we’ll ask for a supporting declaration from their most recent regulator, but we’ll also need a more recent supporting declaration as well.

In this instance, and for those who have never held registration before, they’ll need to provide a different supporting character declaration. Depending on the candidate’s circumstances, we may ask for this from their training institute, former healthcare employer, NMC or other UK healthcare registrant.

We’ve also aligned our police clearance requirements with UK Visas and Immigration requirements. This means that candidates under the new process will need to provide:

1. A police clearance from each country that they have lived in for 12 months in the past ten years while over the age of 18
2. A UK DBS certificate if they’ve been in the UK more than three months at the time of their application

Under the current process candidates are required to provide a certificate of good standing from each country (or state) where they practised and/or been registered.


There is no change to the English language requirements.

Improved guidance and support

We’re redesigning the way we present guidance on our website so that candidates, and those who support them, have a better understanding of our requirements, what we ask for and why, and the process they can expect to follow.

This information will be clearer, easy to read and accessible across a range of devices.

We’re also creating a pre-application checklist tool for candidates to check how ready they are to apply and see what evidence they need to prepare. They’ll be able to download and share their checklist results with others, like employers or recruiters.

New test of competence

Early in 2020 we’re launching a new test of competence in line with our future nurse standards. The company that is designing the new test will produce a range of materials to help candidates prepare.

We’re also creating a new ‘assurance panel’ to oversee the quality and consistency of the test – this will be made up of a group of experienced nurses, midwives and other health and care professionals.

What we’ve changed so far

Where we could do so quickly and safely, we’ve already acted on feedback and made improvements to the process.

Test of competence

Updated OSCE resit policy – candiates now only have to re-sit the part of the OSCE that they failed
Improved preparation materials – we’ve aligned OSCE preparation materials across our three test sites, produced ‘top tips’ for candidates and introduced a mock examination and marking criteria to support candidates preparing for the OSCE examination
Reduced cost – we reduced the overall cost of the test of competence by more than 20 percent – the cost of the CBT reduced from £130 to £90; the full cost of OSCE from £992 to £794 and the resit cost of the OSCE from £496 to £397

Registration requirements

    Updated English language requirements
– we now accept an overall score of 7.0 on the International English Language Test System (IELTS) with a minimum of 6.5 in writing and a minimum of 7.0 in listening, reading and speaking
Removed 12 months’ post registration experience requirement

Shortage of Nurses: Hospital CEOs in UK Told To Travel Out to Hunt for Foreign Nurses

Hospital bosses should personally fly to low and middle income countries in a bid to recruit more foreign nurses to work in the NHS, policy experts have said.

Richard Murray, chief executive of the King’s Fund, said delegating hiring to private agencies risked Britain losing the “international competition” for foreign nurses and exacerbating staff shortages.

Instead, frontline managers and clinicians should travel to recruitment hotspots such as Manila and Delhi to personally sell the merits of a career in their hospital or region, he said.

A major joint report this week by the King’s Fund, Nuffield Trust and Health Foundation predicts that nurse shortages in England will double to 70,000 in 2023-24 at the current rate.

The research partly blamed a four per cent drop in domestic applications for training places following the abolition of bursaries for nursing students in 2016.

Despite the shortage, the NHS in England is recruiting fewer trained nurses from abroad than in 2001 – around 1,600 currently – and should aim to increase this by an additional 5,000, the report found.

“There is big competition across the world these days for nursing staff because there is a global shortage,” said Mr Murray, who was formerly director of strategy at the Department of Health.

“NHS bosses should not rely solely on recruitment agencies to find overseas staff.

“They should play an active role in the effort, working across regions to coordinate efforts.”

On top of difficulties attracting foreign nurses to the NHS in the first place, trusts often struggle to retain the staff beyond one or two years. Mr Murray said this is because foreign nurses too often arrive lacking a clear idea of what living and working in Britain will be like, particularly those recruited to rural areas.

The report found that trusts such as Yeovil District Hospital have surmounted this by sending senior staff on up to three recruitment drives in a single year to the Philippines and Dubai, where they were able to personally advocate the merits of life in rural Somerset.

At one point last year the trust did not have a single nursing vacancy on any of its wards. It is now recruiting on behalf of several other NHS organisations, a model already adopted in the North of England.


[hospital managers ]

are best placed to assess applicants and can offer an honest opinion of life in the UK and the realities of working in the NHS,” said Murray.

“This approach has benefits for the new recruit and the NHS. “It allows overseas professionals to make an informed decision about whether to relocate to the UK, and it helps NHS trusts to select applicants who are attracted to the qualities of their local area.”

Critics have accused clunky visa rules for applicants from non-European Economic Area countries for hampering the recruitment effort.

However, some of these have been recently relaxed, such as a cap on the number of workers in certain salary groups.

So-called Tier 2 visas demand a £30,000 minimum salary, but the Home Office has confirmed that the nursing will remain on a shortage occupation exemption list until 2021, when the policy will be reviewed.
Source :

How Nurse Can Relocate to UK with their Spouse




*By Emeka Nwosu*


If you are a nurse in this group,you need to know the following:


1. It is best if you travel together with your husband,the process is easier,you only need to present your marriage certificate and any other supporting document like few wedding pictures to prove your marriage status.


2. You will pay for visa application about 800 dollars and National health insurance surcharge for your husband,this will cost about 600 pounds for 3 years,an increase is proposed for NHS surcharge but it is yet to be implimented.


3. You can use your Certificate of sponsorship to apply for yourself and your husband if you do not have children yet or you are not travelling with your children,all you need extra is to have some money to lodge your husband in a hotel and then get a place after you must have arrived the UK,a house to be shared with others will be most preferable as you try to adapt and know exactly what will suite the family.


4. If you want to come with your children,you need to keep 630 pounds for each of your children,this money should be in your bank account or that of your husband for a period of 3 months,this is an evidence that you have money to support your family until your husband stabilizes,so make arrangement for this money to be kept in your account once you pass your CBT,even before you get an agency to process your relocation to make it smooth,you will also pay visa application fee,health insurance surcharge for each of your children,i usually advice people to come with their spouse and maybe a child,depending on how much you have,it is also adviceable to borrow this money and keep in the bank,borrow and pay when you come over,it will be more than worth it i can gurantee you that.


5. Immediately your husband arrives, and collects his residence permit,you can help him to call National insurance office that same day to book an appointment for National insurance number interview,he can only work when he has gotten this number and it takes 2 to 3 weeks,yours is provided even before you arrive by your employers so you dont have to apply.


6.You need to inform your huband that their are plenty of job for him to choose from but it will come with time, he can start with a support work job which is easily available even without experience,support work deals with observing children,youth and young adults in various settings to ensure that theu are safe,supported with daily living,you will be well paid enough to pick your bills while you plan for your dream job.


7. Fire men,Prison Officers with other military jobs are currently available,they are well paid jobs,Africans with resident permits are qualified and can key in to this opportunities.


8. If your husband or spouse is an Engineer,skilled worker of any field including accountant,Geologist,information technology and any other field that may not be included in their high demand list,i want to assure you that many people are getting jobs in these areas based on their level of experience,he can move with you,attend job interviews within his field,chances of securing a job is over 70 percent,you may not get the best innitially but what you will get will be worth the risk of relocation.


9. Please ensure that you get an international drivers licence while coming,it will cost you between 25 to 30 thousand in naira,you will be glad you did, their driving test that can give you a licence to drive in the UK is quit challenging so you need a licence that can help you drive and gain on hand experience before picking up their exam and licence,you will thank me latter.


10.Start small,small apartment,small job,small income,small location and grow from there,you cannot get it all at once if you want to be happy,take a gradual step,dont compete with anyone,avoid London as much as you can with its surrounding cities,they are ridiculously expensive.


11. Learn how to do little house repairs,how to change your ligh

UK NMC 2018 Review of Nursing Registration Process for Foreign Nurses

The nurses and midwives on our register must meet the same high standards we set, no matter where they’ve trained.


Because nurses and midwives from outside the EEA won’t have trained in the UK against our standards, we have additional processes in place to check that they meet our requirements.


We’re now reviewing our existing processes to make sure these are as straightforward as they can be and that we provide the right level of support to everyone who wants to register with us.


Why we’re carrying out a review

Our current overseas process has been in place since 2014. We know that there are many areas where it could be improved and we’ve had feedback from applicants and employers on their experiences that we want to respond to so that we can make our processes simpler and quicker for candidates.


We also need to update our tests and processes to reflect our new education standards, as well as the introduction of nursing associates, a new healthcare role, in January 2019.


What we’re reviewing

We’re reviewing all parts of our registration process including how candidates submit their application, the fees they pay, how they demonstrate they meet our UK standards and the evidence we require of their English language capability.


As part of this we’re looking to introduce a new system that will allow applicants to prepare and submit their application to us online and track its progress.


Give us your views

We want to hear about your experiences of our overseas registration process and your views on how it could be improved.


You can hear more about our proposals, ask questions and share your views at one of our upcoming events.


These will be a mix of group workshops and online webinars.


To attend the webinar go to

NMC OSCE Review: OSCE Revision For Nurses

APIE commonly mistakes:
1. Hand hygiene frequency
2. 3-way check identification
3. Allergy to food, drugs, and latex -its reactions as well
4. Preferred Name to be called my patient
5. Incomplete Obs Chart
6. Incorrect NEWS scoring (did not include Oxygen to the score)
7. Full 2mins checking of PR and RR
8. Did not properly address traps (table, stick, pillows on top)
9. Call bell
10. Showing compassion to the patient
11. Not having a S.M.A.R.T. planning
12. Did not include specific time and date in the re evaluation plan.
13. Copying of interventions from the 1st planning problem
14. Signature and Safe in Planning
15. Paracetamol traps in the implementation.
(overdosage 4grams/day only, patient underweight, previously given paracetamol, specific instruction to give – ex. for pyrexia)

16. Giving meds that is due for tomorrow
17. Not enough time in the implementation
18. Did not address the IV
19. Double checking of identity in the implementation
20. Touching the tablet.
21. Forgot to check drug expiry
22. Wrong dosage given
23. Forgot to inform patient of the drug’s indication and side effects.
24. Not giving tablets in separate drug cup.
25. Allergy to Penicillin – given Co Amoxiclav
26. Forgot to code drugd not given and write at the back of drug chart
27. Did not see the drug was coded by other nurse thereby including it to the drugs given in the evaluation.
28. Did not sign and write date in the evaluation.
29. Did not include the diagnosis in the reason for admission
30. Write or added an info in the evaluation which was not done in the API.
31. Incomplete drugs in the drugs given and drugs omitted in the evaluation.

NMC IELTS News: Relaxing of Nurse Language Test Welcomed


A DECISION to relax stringent language tests for foreign nurses has been welcomed.

The move by the Nursing and Midwifery Council (NMC) could help ease GWH’s nursing shortages, directors said.

All nurses and midwives who want to work in the UK must register with the NMC.

Up until now, foreign nurses were required to pass the International English Language Test System (IELTS) – an exam branded as too broad and not sufficiently nursing-related by many would-be UK health workers.

However, from this week the NMC will accept the more work-based Occupational English Test (OET) as an alternative for nurses keen to work in the UK.

Additionally, foreign nurses will be allowed to register with the NMC without passing the language tests if they can prove that they have taken a nursing qualification taught and examined in English or practiced for at least a year in a country where English is the first and native language.

The move has been welcomed by bosses at Great Western Hospital NHS Foundation Trust.

At a meeting of the trust’s board of directors, chief nurse Hilary Walker said that the new English language tests were “helpful, in as much as nurses will be examined in the context of healthcare”.

The hospital has six people booked onto the first available OET exam in December.

In an interview with the Adver last week, Lili Baleanu, a staff nurse who travelled to Swindon from Romania, questioned the value of the IELTS.

“It is a very difficult exam, especially because it has nothing in common with nursing. They want you to have an academic level of English. They’ll ask you about anything,” said Lili, who was asked to write an essay about fuels for one test paper.

GWH’s human resources chief welcomed the changes to the qualification requirements – but said that more work was needed to make it easier to recruit from abroad.

HR director Oonagh Fitzgerald told the Adver: “We are pleased the Nursing and Midwifery Council has acted on the concerns that many NHS organisations, including ours, have had for some time about the lengthy process fully qualified nurses from overseas have to go through to demonstrate their knowledge of the English language.

“However, we still feel these changes do not go far enough in making the NHS – one of the most highly regarded employers in the world – accessible to the thousands of healthcare staff across the globe who aspire to bring their talent and skills to the UK.

“While there clearly is a need for a robust testing system, it needs to be one that works for all healthcare staff and until we get to that point, we will continue to call for further changes to be made.”


NMC CBT Sample Questions and CBT Exam Practice 7

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. According to law in England, UK when you faced with a situation of emergency what is your action?
• Should not assist when it is outside of work environment
• Law insists you to stop and assist
• You are not obliged in any way but as a professional duty advises you to stop and assist
• Do not involve in the situation
2. Which of the following actions jeopardise the professional boundaries between patient and nurse
• Focusing on social relationship outside working environment
• Focusing on needs of patient related to illness
• Focusing on withholding value opinions related to the decisions
3. An elderly client with dementia is cared by hid daughter. The daughter locks him ina room to keep him safe when she goes out to work and not considering any other options. As a nurse what is your action?
• Explain this is a restrain. Urgently call for a safe guarding and arrange a multi-disciplinary team conference
• Do nothing as this is the best way of keeping him safe
• Call police, social services to remove client immediately and refer to safeguarding
• Explain this is a restrain and discuss other possible options
4. An elderly client tells you that the carer is using his money when going for shopping and not buying him any food. The client appears malnourished and weighing only 35 kgs. As a newly qualified nurse what is your action?
• Listen to client and raise concern with line manager
• Do nothing as he is confused
• Listen to the client and call safeguarding lead
• Listen to the client and confirm with the carer
5. A Chinese woman has been admitted with fracture of wrist. When you are helping her undress you notice some bruises on her back and abdomen of different ages. You want to talk to her and what is your action
• Ask her husband about the bruises
• Ask her son/ daughter to translate
• Arrange for interpreter to ask questions in private
• Do not carry any assessment and document this is not possible as the client cannot speak English

6. Nurse caring a confused client not taking fluids, staff on previous shift tried to make him drink but were unsuccessful. Now it is the visitors time,wife is waiting outside What to do?
• Ask the wife to give him fluid, and enquire about his fluid preferences and usual drinking time
• Tell her to wait and you need some time to make him drink
• Inform doctor to start iv fluids to prevent dehydration
7. .A new RN have problems with making assumptions. Which part of the code she should focus to deliver fundamentals of care effectively
• Prioritise people
• Practice effectively
• Preserve safetey
• Promote professionalism and trust
8. Risk for health issues in a person with mental health issues
• Increased than in normal people
• Slightly decreased than in normal people
• Very low as compared to normal people
• Risk is same in people with and without mental illness
9. What is the use of protected meal time?
• Patient get protection from visitors
• Staff get enough time to have their bank
• To give personal hygiene to patients who are confused
• Patients get enough time to eat food without distractions while staff focus on people who needs help with eating
10. Food rich in antioxidants
• Tomato broccoli carrot
11. Prions are present in
12 .A slow and progressive disease with no definite cure,only symptomatic Management?
• Acute
• Chronic
• Terminal
13.An infectious patient is kept in isolation and are advised to take standard precaution. How maintained?
• waste bin ,handrub, gloves gown and mask available in room. Information leaflet attached on door
• Gloves gown and mask given to the patient
• Gloves gown and mask placed inside the room and waste disposal facilitied are kept outside
• waste disposal facilities arranged inside room ,Gloves mask apron and handrub arranged on a trolly ouside room next to door.
14.How can a patient involved in patient centerd care?
• Assessing patient health care needs with the other members of the health care team
• Engaging patient in conversation assessing and identifying needs by involving client focusing on preferences and formulating plan accordingly.
• Engaging patients in discussion and focusing care based on his medical condition
15.You are mentoring a 3rd year student nurse, the student request that she want to assist a procedure with tissue viability nurse, howcan you deal with this situation
• Tell her it is not possible
• Tell her it is possible if you provide direct supervision
• Call to the college and ask whether it is possible for a 3rd student to assist the procedure
• Allow her as this is the part of her learning

16.Which drug can be given via NG tube?
• Modified release hypertensive drugs
• Crushing the tablets
• Lactulose syrup
• Insulin

17. Why constipation occurs in oldage?
• Anorexia and weight loss
• Decreased muscle tone and periatalsis
• Increased mobility
• Increased absorption in colon
18.Independent and supplementary nurse and midwife are those who are?
A. nurse and midwife student who cleared medication administration exam
B. nurses and midwives educated in appropriate medication prescription for certain pharmaceuticals
C. registrants completed a programme to prescribe under community nurse practitioner’s drug formulary
D. nurses and midwives whose name is entered in the register
19.An unmarried young female admitted with ectopic pregnancy with her friend to hospital with complaints of abdominal pain. Her friend assisted a procedure and became aware of her pregnancy and when the family arrives to hospital, she reveals the truth. The family reacts negatively. What could the nurse have done to protect the confidentiality of the patient information?
a. should tell the family that they don’t have any rights to know the patient information
b. that the friend was mistaken and the doctor will confirm the patient’s condition
c. should insist friend on confidentiality
d. should have asked another staff nurse to be a chaperone while assisting a procedure
20. In a G.P clinic when you assessing a pregnant lady you observe some bruises on her hand. When you asked her about this she remains silent. What is your action?
• Call her husband to know what is happening
• Tell her that you are concerned of her welfare and you may need to share this information appropriately with the people who offer help
• Do nothing as she does not want to speak anything
• Call the police
21. As a RN when you are administering medication, you made an error. Taking health and safety og the patient into consideration, what is your action?

• Call the prescriber. Report through yellow card scheme and document it in patient notes
• Let the next of kin know about this and document it
• Document this in patient notes and inform the line manager
• Assess for potential harm to client, inform the line manager and prescriber and document in patient notes
22. you have assigned a new student to an experienced health care assistant to gain some knowledge in delivering patient care. The student nurse tells you that the HCA has pushed the client back to the chair when she was trying to stand up. What is your action
• Suspend HCA immediately
• Intervene on spot and raise concern immediately to the manager on duty
• Ask the client later on what has happened
• Ignore the student as she is new and does not have any experience
23. a newly admitted client refusing to handover his own medications and this includes controlled drugs. What is your action?
• You have to take it any way and document it
• Call the doctor and inform about the situation
• Document this refusal as these medications are his property and should not do anything without his consent
• Refuse the admission as this is against the policy
24. A nurse is not allowing the client to go to bed without finishing her meal. What is your action as a RN?
• Do nothing as client has to finish her meal which is important for her health
• Challenge the situation immediately as this is related to dignity of the patient and raise your concern
• Do nothing as patient is not under your care
• Wait until the situation is over and speak to the client on what she wants to do
25. A client had fractured hand and being cared at home requiring analgesia. The mediaction was prescribed under PGD. Whaich of the following statements are correct relating to this
• A PGD can be delegated to student nurse who can administer medication with supervision
• PGD’s cannot be delegated to anyone
• This type of prescription is not made under PGD
• This can be delegated to another RN who can administer in view of a competent person
26. you are transcribing medications from prescription chart to a discharge letter. Before sending this letter what action must be taken?
• A registrant should sign this letter
• Transcribing is not allowed in any circumstances
• The letter has to be checked by a nurse in charge
• Letter can be sent directly to the patient after transcribing
27. when explaining about travellers’ diarrhoea which of the following is correct?
• Travellers’ diarrhoea is mostly caused by Rotavirus
• Antimotility drugs like loperamide is ineffective management
• Oral rehydration in adults and children is not useful
• Adsorbents such as kaolin is ineffective and not advised
28. most of the s/s are common in both type1 and type 2 diabetes. Which of the following symptom is more common in typ1 than type2?
• Thirst
• Weight loss
• Poly urea
• Ketones
29. As a nurse you are responsible for looking after patient’s nutritional needs and to maintain good weight during hospitalization. How would you achieve this?
• Providing all clients with liquid nutritional supplements
• Assessing all patients using MUST screening tool and by taking patients preferences into consideration
• Checking daily weigh and documenting
• Assessing nutritional status, client preferences and needs, making individual food choices available, checking daily weight and documentation
30. when do you wear clean gloves?
• Assisting with bathing
• Feeding a client
• When there is broken skin on hand
• Any activity which includes physical touch of a client
31. when delegating any task to any one what you must needto consider?
• Delegating according to job description
• Delegating tasks to student nurses they can be able to do
• Delegating tasks only to health care assistans
• Before delegating tasks to anyone, have to make sure that person is competent and able to carry the task
32. if a client is experiencing hypotension post operatively, the head is not tilted in which of the following surgeries
• Chest surgery
• Abdominal surgery
• Gynaecological surgery
• Lower limb surgery
33. A client is diagnosed with hepatitis A. which of the following statements made by client indicates understanding of the disease
• Sexual intimacy and kissing is not allowed
• Does require hospitalization
• Transmitted only through blood transfusions
• Any planned surgery need to be postponed
34. which of the following statements made by client diagnosed with hepatitis A needs further understanding of the disease.
• Washing hands before cooking food
• Refraining from sexual intimacy and kissing while symptoms still present
• Towels and flannels can be shared with children
35. clinical practice is based on evidence based practice. Which of the following statements is true about this
• Clinical practice based on clinical expertise and reasoning with the best knowledge available
• Provision of computers at every nursing station to search for best evidence while providing care
• Practice based on ritualistic way
• Practice based on what nurse thinks is the best for patient
36. gurgling sound from airway in a postoperative client indicates what
• Complete obstruction of lower airway
• Partial obstruction of upper airway
• Common sign of a post-operative patient
• Indicates immediate insertion of laryngeal airway
37. when breaking bad news over phone which of the following statement is appropriate
• I am sorry to tell you that your mother died
• I am sorry to tell you that your mother has gone to heaven
• I am sorry to tell you that your mother is no more
• I am sorry to tell you that your mother passed away
38. after breaking bad news of expected death to a relative over phone , she says thanks for letting us know and becomes silent. Which of the following statemnts made by nurse would be more empathetic
• Say I will ask the doctor to call you
• You seem stunned. You want me to help you think what you want to do next
• Call me back if you have got any questions
• Say can I help you with funeral arrangements
39. signs and symptoms of septic shock?
• Tachycardia, hypertension, normal WBC, non pyrexial
• Tachycardia, hypotension, increased WBC, pyrexial
• Tachycardia, , increased WBC, normotension, non pyrexial
• Decreased heart rate, decreased blood pressure, normal WBC and pyrexial
40. during busy shift, a nurse loads medication and asks you to administer it. What is your action?
Ask student nurse to help you administer medication
Ask another staff nurse to help you with administering medication
Accept to administer the medication
Refuse to administer the medication
41. a patient with learning disability is accompanied by a voluntary independent mental capacity advocate. What is his role?
• Express patients needs and wishes. Acts as a patients representative in expressing their concerns as if they were his own
• Just to accompany the patient
• To take decisions on patients behalf and provide their own judgements as this benefit the client
• Is a expert and representates clients concerns, wishes and views as they can not express by themselves
42. Position to make breating effective?

• -left lateral

• -Supine

• -Right Lateral

• -High sidelying

43. which solution use minimum tissue damage while providing wound care
• Hydrogen peroxide
• Povidine iodine
• Saline
• Gention violet
44. A patient with burns is given anesthesia using 50%oxygen and 50%nitrous oxide to reduce pain during dressing . how long this gas is to be inhaled to be more effective
• 30 sec
• 60sec
• 1-2min
• 3-5min
45. Reason for dyspnoea in patients who diagnosed with Glomerulonephritis patients?
• Albumin loss increase oncotic pressure causes water retention in cells
• Albumin loss causes decrease in oncotic pressure causes water retention causing fluid retention I alveoli
• Albumin loss has no effect on oncotic pressure
46. An RN is working in a team.Who is responsible for her action?
• Charge nurse
• Herself
• Doctor
• Supervisor
47. Why is it essential to humidify oxygen used during respiratory therapy?
• Oxygen is a very hot gas so if humidification isn’t used, the oxygen will burn the respiratory tract and cause considerable pain for the patient when they breathe.
• Oxygen is a dry gas which can cause evaporation of water from the respiratory tract and lead to thickened mucus in the airways, reduction of the movement of cilia and increased susceptibility to respiratory infection.
• Humidification cleans the oxygen as it is administered to ensure it is free from any aerobic pathogens before it is inhaled by the patient.
• Humidifying oxygen adds hydrogen to it, which makes it easier for oxygen to be absorbed to the blood in the lungs. This means the cells that need it for intracellular function have their needs met in a more timely manner.
48. A patient on your ward complains that her heart is ‘racing’ and you find that the pulse is too fast to manually palpate. What would your actions be?
• Shout for help and run to collect the crash trolley.
• Ask the patient to calm down and check her most recent set of bloods and fluid balance.
• A full set of observations: blood pressure, respiratory rate, oxygen saturation and temperature. It is essential to perform a 12 lead ECG. The patient should then be reviewed by the doctor.
• Check baseline observations and refer to the cardiology team.
49. What is the most accurate method of calculating a respiratory rate?
A. Counting the number of respiratory cycles in 15 seconds and multiplying by 4.
B. Counting the number of respiratory cycles in 1 minute. One cycle is equal to the complete rise and fall of the patient’s chest.
C. Not telling the patient as this may make them conscious of their breathing pattern and influence the accuracy of the rate.
D. Placing your hand on the patient’s chest and counting the number of respiratory cycles in 30 seconds and multiplying by 2.
50. What specifically do you need to monitor to avoid complications and ensure optimal nutritional status in patients being enterally fed?
A. Blood glucose levels, full blood count, stoma site and bodyweight.
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.
51. signs and symptoms of compensated shock
52. signs and symptoms of anemia in old age
53. signs and symptoms of anxiety
54. signs and symptoms of speed shock
55. little or no urine output termed as?
56.cvp line measures?
• Pressure in right atrium
• Pulmonary arteries
• Left ventrivle
• Vena cava
57. Normal value of oxygen saturation
58. Normal value of blood pH

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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?
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

NMC CBT Sample Questions and CBT Exam Practice 5

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)mild pain after surgery and pain is reduced by taking which medicine
c)paracetamol with codeine
d)paracetamol with morphine

2)Earing aid provide to client comes under which act?
a)communication act
b)mental capacity act
c)children and family act.

3)24 hrs after abdominal surgery pain is not reduced what management will provide
a)heat pad
b) reclined position
c)call doctor

4)patient thinks that he is over weight so nurse send that patient to
c)mental health team

5)active listenting means
a)verbal communication
b)non verbal communication
c)verbal and non verbal communication

6)how the nurse assess the quality of care given
a)reflective process
b) clinical bench marking
c)peer and patient response
d)all the above

7) oral corticosteriods side effect
a)mood variation

8)obesity is one of the main problem.what might cause this?
b) unequality
c)low economic class

9)constipation needs to be sort out during

10)vital signs how periodically needs to be checked by the nurse during admission?
a)during admission
b)morning and evening
c)according to patient condition

11.Management of moderate malnutrition in children?
-supplimentary nutrition
-immediate hospitalization
-weekly assessment
-document intake for three days
12.which drug to be avoided by a patient on digoxin?

13.what is the meaning of compassion? orthostatic hypotension happens?
15.NEWS score of 5-what action is appropriate?
-increase frequency of observation
-physician review
-tranfer patient to critical care unit

16. 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

17. 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

18. What should be included in your initial assessment of your patient’s respiratory status?
A. Review the patient’s notes and charts, to obtain the patient’s history
B. Review the results of routine investigations
C. Observe the patient’s breathing for ease and comfort, rate and pattern
D. Perform a systematic examination and ask the relatives for the patients history

19. Why are anti- embolic stockings an effective means of reducing the potential of developing a deep vein thrombosis(DVT)
A. They promote arterial blood flow
B. They promote venous blood flow
C. They reduce the risk of postoperative swelling
D. They promote lymphatic fluid flow, and drain

20. .When will you disclose the identity of a patient under your care?
a. Justified by public interest law and order
b. When media demands for it
c. When patient relatives wishes to
d. You can disclose it anytime you want

21. 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 time for answering questions, and inviting voluntary participation
22.Which behaviors will encourage a patient to talk about their concerns?

23..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
24. .adverse reaction repoting
-yellow card
25.while mentoring a final year student dispensing medication .nurse role ?
-direct supervision
-before delegating find out he is competemnt
-ask himt to tell after the administration is complete
26.electonic data transfer is more these days, which of the report is not suitable to sent to a discharged client ?
-Abnormal blood report
-smoking caessation policy
-diet plan
27.primary care ?
-care provided in acute settings
-first hand care appoach made by pt
28.. Why old people afebrile even if they are infected ?
-immature mast T- lymphocYtes
interuuption of non adrenaline activity
29.dehydration in old adult ?(2)
30. You noticed medical equipment not working while you joined a new team and the team members are not using it. Your role?
-during audit raise your concern
-inform in written to management
-inform nmc
-take photograph
31. 86. Heart rate below 50?
ans. Bradycardia
32. .proper technique to use walke?.
-move 10 feet, take small steps
-move 10feet, take large wide steps
-move 12feet
-tansform weight to walker and walk
33. ideal site for IM INJECTIONS in buttocks region ?
ans. upper outer quadrant
34. 109.after abdominal complains of pain even after administration of analgesics little ago?
-apply heat
-position to reclined positon
-Call the doctor
-Read minister analgesic
35.after laminectomy how to turn patient ?
– Turned as a unit states “i hate cancer”according to kobler theory this is
37.proper method to collect urine sample?
ans. clean meatus and collect midstream the day of discharge spouse of a pt is tensed about discharge ?
-cancel discharge
-Explain the pt to express his fears and fix time for consultation
-inform the doctor care assistant task delegation criteria?
-make sure he is competent
-make sure he is experienced
-confirm that he is a staff having same designation
-he is an employee of the same institution
40.while dealing with a pt,sexualityaganist nurses belief ?

41. What is the min required hours for in service education in uk for 3 years?
• 25
• 35
• 45
• 55
42. An adult is offered the opportunity to participate in research on a new therapy. The researcher ask thenurse to obtain the patient’s consent. What is most appropriate for the nurse to take?
1) Be sure the patient understands the project before signing the consent form
2) Read the consent form to the patient & give him or her an opportunity to ask questions
3) Refuse to be the one to obtain the patient’s consent
4) Give the form to the patient & tell him or her to read it carefully before signing it.

43. What do you mean by code of ethics?
Legal activities of a registered nurse who work in the UK
Legislative body to control nurses

44. A client is diagnosed with cancer what is your response?
Take her to another room and allow her to discuss with the husband
Tell them to wait in the room and I will come and talk to u after my duty
45. Notifiable disease
Swine fue
46. A registered nurse is new to the diagnosis of a patient who came for treatment, what to do?
Clarify doubts with senior staff and plan nursing care accordingly
Read books about the condition and start working with confidence
47. You observed that a nurse has not washed the hands before touching patient what to do?
Interrupt and ask to wash hands
Call the nurse privately and talk about this later
48. What is the first action before doing primary assessment of a patient
Arrange articles
Provide privacy
Hand wash
49. How to reduce the risk of injury to an adult patient by identifying?
When , where, and why
Type of risk, source and measures to prevent
Age of patient, environment and ……
50. Contigency theory
Keeping big picture and assessing the capacity of staffs
51. What is not useful of early ambulation?
Reduce wound infection
Reduce chest infection
Reduce DVT
52. Why should nurse encourage family members to speak with patient with coma in end of life.
To give psychological support to the family
Hearing is the last sense to end
It is the responsibility of nurse to tell
53. Who should do the assessment in a patient with dysphagia
Neurologic physiotherapist
Speech therapist
Occupation therapist
54. A patient is rapidly deteriorating due to drug over dose what to do?
Assess ABCDE, call help, keep anaphylactic kit
Call for help, keep anaphylactic kit, assess ABCDE
Assess ABCDE, keep anaphylactic kit, inform doctor, call for help
55. When you identify a child abuse what will you do?
Raise concern for child and inform manager
Inform social service group
Inform manager and help to investigate with her
56. A client wants to go home against medical advice but not mentally competent what to do?
Inform security to hold the patient until doctor finishes his assessment.
Release the patient as patient priority need to be considered.
57. Patient relative want to visit the patient who is admitted with diarrhea what to tell?
Tell her to wait for 48 hours
Tell her to come and see the patient after symptoms subside.
Tell her to see the patient but don’t touch her
58. What is the expansion of APVU?
59. Controlled drug delivery to patient?
60. When a patient ask to keep a secret what is best to say?
As I would like you to develop trust on me, I will keep it as a secret
My professional ethics do not permit me to disclose any information of patient secrets, so I will keep it as a secret.
61. A patient with stoma complaints that the stoma bag is loose and the area is rigid what is your best action?
Teach the patient about diets and wound management.
Encourage the patient to consult a doctor
Assess the stoma site and refer the patient to a stoma nurse.
62. What is right in case of consent among children under 18.
Only children between 16-18 are competent to give it
Parents are responsible to give consent with children
Children who are intellectually developed and understand matters can give consent.
63. A student nurse is busy with her mobile and not listening what to do?
Call her personally and discuss about this later when both of you are free.
Tell her politely to stop what she is doing and ask her to join with the education
64. How to communicate with the conditions of patients in a psychiatric unit
Mental status examination
Group discussions
Core nursing process
65. A patient relative complaints that her mother is not yet bathed by the nurse what is the best action?
Accept it , tell them that we will investigate about this and meet the areas of need
Appreciate for complaining and make sure that the patient is bathed.
66. You observe that the staff is threatening aged patient, best action?
Immediately stop her and encourage the patient to make a complaint against the staff
Immediately stop the staff and raise concern about the patient who is weak and aged.
67. Audit in nursing means
Identify the errors and problems
Assess the areas of improvement.
68. Your nurse manager approaches you in a tertiary level old age home where complex cases are admitted, and she tells you that today everyone should adopt task – oriented nursing to finish the tasks by 10 am whats your best action
Discuss with the manager that task oriented nursing may ruin the holistic care that we provide here in this tertiary level.
Ask the manager to re-consider the time bound, make sure that all staffs are informed about task oriented nursing care
69. What do you mean by tertiary care?
Palliative, rehabilitation, step dawn patients, long term illness
70. IV injection need to be reconsider when,?
Medicine is available in tab form
Poor alimentary absorption
Drug interaction due to GI secretions.
71. Doctor visit the patient after a typical surgery, and patient inform the doctor that the surgery is not successful. Doctor ask you to be with the patient until the senior nurse arrves. What is your best action during that time ?
Be with the patient without doing anything.
Ask the patient to tell what doctor said
Note down the information in nurses notes
72. Common type of drug error due to pressureful situation?
Wrong dose, identity
Prescription error
Look alike sound alike drugs error
73. When you observe a patient has gum bleeding during brushing her teeth this may indicate?
A disease
Poor diet
Complication of medication
74. What is the terminology for cannot speak due to stroke?
75. A patient with complex, multiple diseases is discharged to a teritary level care unit what to do?
Inform the teritary unit about patient arrival
Call for a multidisciplinary meeting with professional who took care of patient to discuss the patient care modalities that everyone accepts.
Inform to patient relatives abot the situation
76. Which is not effective in respiratory therapy?
Relaxation technique by traditional healer
Something “CRYSTAL therapy
77. You observe a new staff who always ask others before doing things since she is not confident enough to do things and unaware of the unit. What conclusion you will make.?
Accept limitation and ask doubt to promote patient safety
Unaware of matters and may risk the patient life
Incapabile of doing things
78. You observe that a staff is doing poor documentation and find difficult to continue the next shift due to this problem what to do?
Talk with her privately and teach her how to do better documentation
Inform her that this activity may affect patient care and it is not acceptable.
79. What do you mean by a bad leadership?
Appreciate initiativeness
Appreciate better work
Reward poor performance
80. What do u mean by contingency theory?
81. According to Francis study what do you mean by courage by the nurse?
82. What is the sign of denture stomatitis?
83. When you find out that 2 staffs are on leave for next duty shift and its of staff shortage what to do with the situation?
Inform the superiors and call for a meeting to solve the issue
Contact a private agency to provide staff
Close the admission until adequate staffs are on duty.
84. What will u do if you observe a patient with poor nutrition?
Start nutritional supplements
Inform doctor
Refer to dietician.
85. medium diet score for a patient? What is the immediate action…
its related to a tool that is used to assess the nutritional status of patients in the uk.
86. What should teach the patient who take tab. Allopurinol
Drink lots of water
Avoid caffeinated beverages
87. According to the royal marsden manual, a staff who observe the removal of chest drainage is considered as?
Official training
Unofficial training
Hours which are not calculated as training hours
It is calculated as prsecribed training hours.
88. Was not competent enough to give a tablet prescribed by a doctor? What to do
Don’t administer & Inform doctor
Don’t administer & Inform manager
89. What is mean by delegation to an assistnt
Authority is delegated to the other
Responsibility is not delegated
The Nurse is responsible for the overall work
90. How to manage the infectious linen?
91. A patient with dementia is mourning and pulling the dress during night what do you understand from this?
Patient is incontinent
Patient is having pain
Patient has medication toxicity.
92. pt bring own medication to hospital and wants to self administer. your role ?
allow him
give medications back to relatives to take back
keep it in locker,use from medication trolly
explain to pt about medication before he administer it
93. how can we identify health problems of a patient ?
-medical notes
-Talking to their friends
94. care, competence, courage, compassion, commitment is ?
6 C’S
Professional values.
95. the one who develops and providing information?
a) nurse educator
b) nurse advocate
Ç) nurse researcher
D) nurse practioner

96.what is empathetic nursing?
97. how to position a patient with lumbar laminectomy?
98. What is clinical benchmarking?
99.what is compassionate nsg?
100. In the department where the RN works hoist is not working and there is rosk to the patient safety,what is the responsibility of RN?
a)report to management team
b) telephone and report to CQ
c)report during team meeting

101. what is primary care level setting?
102. drug interactions with digoxin?
103. Prions found in which disease.

104. What kind of relation does transformational leader maintain.
105. If u r a mentor of a student nurse, and if the student request u to be with tissue viability nurse, how will u deal.
106. Type 1 DM patient signs and symptoms
107. A post op client who is having hypotension, bed should be tilted in which cases: eg: chest surgery, abdominal surgery,lower limb surgery, gynac surgery.
108. U r calling a pts relative about the expected death, what should be ur way of speaking.
109. 500 ml of 0.9% NS is onflow at 20 ggt/m, the IV safeset 15 drops, how many hours will the saline go.
110. 90 mg of Vail is available, patient’s BSA is 55.4m², calculate the dose
111. A patient with CRF has which all symptoms
112. Patient with glomerular nephritis come with symptoms of puffy face,edema,dyspnea. How can dyspnea occur to this patient.
113.Client with neutropenia has which all symptoms
114. In source isolation what all precaution should be followed.

115. Portions included in daily meal
116. Sign and symptoms of compensated shock.

117. Following should be done if patient has pulseless ventricular tachycardia.
118. A client has anaphylaxis reaction,as a community nurse what should u do.
119. a post op patient has gurgling sounds…what is the immediate action
120. An unmarried Muslim is diagnose with ectopic pregnancy, she is accompanied by her friend. When the family arrives, the friend tell them about the pregnancy, the patient mother collapsed, the father leaves the room. What should have RN done in such situations.

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