201. You notice an area of redness on the buttock of an elderly
patient and suspect they may be at risk of developing a pressure ulcer.
Which of the following would be the most appropriate to apply?
A. Negative pressure dressing
B. Rapid capillary dressing
C. Alginate dressing
D. Skin barrier product
A. Negative pressure dressing
B. Rapid capillary dressing
C. Alginate dressing
D. Skin barrier product
202. Which solution uses minimum tissue damage while providing wound care?
A. Hydrogen peroxide
B. Povidine iodine
C. Gention violet
D. Saline
A. Hydrogen peroxide
B. Povidine iodine
C. Gention violet
D. Saline
203. Which are not the benefits of using negative pressure wound therapy?
A. Can reduce wound odour
B. Increases local blood flow in peri-wound area
C. Can be used on untreated osteomyelitis
D. Can reduce use of dressings
A. Can reduce wound odour
B. Increases local blood flow in peri-wound area
C. Can be used on untreated osteomyelitis
D. Can reduce use of dressings
204. Which one of the following types of wound is NOT suitable for negative pressure wound therapy?
A. Partial thickness burns
B. Contaminated wounds
C. Diabetic and neuropathic ulcers
D. Traumatic wounds
A. Partial thickness burns
B. Contaminated wounds
C. Diabetic and neuropathic ulcers
D. Traumatic wounds
205. How do you remove a negative pressure dressing?
A. Get TVN nurse to remove dressing
B. remove in a quick fashion
C. Remove pressure then detach dressing gently
D. Leave it for the nursing staff
A. Get TVN nurse to remove dressing
B. remove in a quick fashion
C. Remove pressure then detach dressing gently
D. Leave it for the nursing staff
206. How would you care for a patient with a necrotic wound?
A. Systemic antibiotic therapy and apply a dry dressing
B. Debride and apply an antimicrobial dressing.
C. Apply a negative pressure dressing.
D. Debride and apply a hydrogel dressing
A. Systemic antibiotic therapy and apply a dry dressing
B. Debride and apply an antimicrobial dressing.
C. Apply a negative pressure dressing.
D. Debride and apply a hydrogel dressing
207.
The nurse cares for a patient with a wound in the late regeneration
phase of tissue repair. The wound may be protected by applying a:
A. Hydrogel dressing
B. Collagenases dressing
C. Wet dry dressing
D. Transparent film
A. Hydrogel dressing
B. Collagenases dressing
C. Wet dry dressing
D. Transparent film
208. Black wounds are treated with debridement. Which type of debridement is most selective and least damaging?
A. Debridement with scissors
B. Debridement with wet to dry dressings
C. Mechanical debridement
D. Chemical debridement
A. Debridement with scissors
B. Debridement with wet to dry dressings
C. Mechanical debridement
D. Chemical debridement
209. If an elderly immobile patient had a 'grade 3 pressure sore', what would be your management?
A. Film dressing, mobilization, positioning, nutritional support
B. Dry dressing, pressure relieving mattress, mobilization
C. Foam dressing, pressure relieving mattress, nutritional support
D. Hydrocolloid dressing, pressure relieving mattress, nutritional support
A. Film dressing, mobilization, positioning, nutritional support
B. Dry dressing, pressure relieving mattress, mobilization
C. Foam dressing, pressure relieving mattress, nutritional support
D. Hydrocolloid dressing, pressure relieving mattress, nutritional support
210.
A client has a diabetic stasis ulcer on the lower leg. The nurse uses a
hydrocolloid dressing to cover it. The procedure for application
includes:
A. Cleaning the skin and wound with betadine
B. Removing all traces of residues for the old dressing
C. Choosing a dressing no more than quarter-inch larger than the wound size
D. Holding it in place for a minute to allow it to adhere
A. Cleaning the skin and wound with betadine
B. Removing all traces of residues for the old dressing
C. Choosing a dressing no more than quarter-inch larger than the wound size
D. Holding it in place for a minute to allow it to adhere
211. The client at greatest risk for postoperative wound infection is:
A. A 3 month old infant postoperative from pyloric stenosis repair
B. A 78 year old postoperative from inguinal hernia repair
C. A 32 year old diabetic postoperative from an appendectomy
D. A 18 year old drug user postoperative from removal of a bullet in the leg
A. A 3 month old infant postoperative from pyloric stenosis repair
B. A 78 year old postoperative from inguinal hernia repair
C. A 32 year old diabetic postoperative from an appendectomy
D. A 18 year old drug user postoperative from removal of a bullet in the leg
212.
Mr Connor’s neck wound needed some cleaning to prevent complications.
Which of the following concept will you apply when doing a surgical
wound cleaning?
A. surgical asepsis
B. medical asepsis
C. dip-tip technique
D. aseptic non-touch technique
A. surgical asepsis
B. medical asepsis
C. dip-tip technique
D. aseptic non-touch technique
213.
When doing your shift assessment, one of your patient has a waterlow
score of 20. Which of the following mattress is appropriate for this
score?
A. waterbed
B. fluidized airbed
C. low air loss
D. alternating pressure
A. waterbed
B. fluidized airbed
C. low air loss
D. alternating pressure
214. Waterlow score of 20 indicates what type of mattress to use?
I. Standard-specification foam mattresses
II. High-specification foam mattresses
III. Dynamic support surface
A. IV
B. I and III
C. I, II and III
D. II and III
I. Standard-specification foam mattresses
II. High-specification foam mattresses
III. Dynamic support surface
A. IV
B. I and III
C. I, II and III
D. II and III
215. For a client with Water Score >20 which mattress is the most suitable?
A. Water Mattress
B. Air Mattress
C. Dynamic Mattress
D. Foam Mattress
A. Water Mattress
B. Air Mattress
C. Dynamic Mattress
D. Foam Mattress
216.
A patient has been confined in bed for months now and has developed
pressure ulcers in the buttocks area. When you checked the waterlow it
is at level 20. Which type of bed is best suited for this patient?
A. water mattress
B. Egg crater mattress
C. air mattresses
D. Dynamic mattress
A. water mattress
B. Egg crater mattress
C. air mattresses
D. Dynamic mattress
217.
You have just finished dressing a leg ulcer. You observe patient is
depressed and withdrawn. You ask the patient whether everything is okay.
She says yes. What is your next action?
A. Say 'Cheer up, Shall I make a cup of tea for you?'
B. Accept her answer & leave. attend to other patients
C. Inform the doctor about the change of the behaviour
D. Say 'I observe you don't seem as usual. Are you sure you are okay?'
A. Say 'Cheer up, Shall I make a cup of tea for you?'
B. Accept her answer & leave. attend to other patients
C. Inform the doctor about the change of the behaviour
D. Say 'I observe you don't seem as usual. Are you sure you are okay?'
218. External factors which increase the risk of pressure damage are:
A. Equipment, age and pressure
B. Moisture, pressure and diabetes
C. Pressure, shear and friction
D. Pressure, moisture and age
A. Equipment, age and pressure
B. Moisture, pressure and diabetes
C. Pressure, shear and friction
D. Pressure, moisture and age
219.
Mr Smith has been diagnosed with Multiple Sclerosis 20 years ago. Due
to impaired mobility, he has developed a Grade 4 pressure sore on his
sacrum. Which health professional can provide you prescriptions for his
dressing?
A. Dietician
B. Social Worker
C. Physiotherapist
D. Tissue Viability Nurse
A. Dietician
B. Social Worker
C. Physiotherapist
D. Tissue Viability Nurse
220. Sharp debridement may cause trauma to underlying structures, the procedure should only be carried out by:
A. A health care assistant on working full time
B. A qualified nurse with at least 3 years’ experience
C. A doctor of any type of speciality
D. A qualified healthcare professional with appropriate training
A. A health care assistant on working full time
B. A qualified nurse with at least 3 years’ experience
C. A doctor of any type of speciality
D. A qualified healthcare professional with appropriate training
221.
Mrs Smith developed an MRSA bacteremia from her abdominal wound and her
son is blaming the staff. It has been highlighted during your ward
clinical governance meeting because it has been reported as a serious
incident (SI). SI is best described as:
A. any incident or occurrence that has the potential to cause harm and/or has caused harm to a person or persons
B. a consequence of an intervention, relating to a piece of equipment and/or as a consequence of the working environment
C. Incident requiring investigation that occurred in relation to NHS funded services and care resulting in; unexpected or avoidable death, permanent harm
D. All of the Above
A. any incident or occurrence that has the potential to cause harm and/or has caused harm to a person or persons
B. a consequence of an intervention, relating to a piece of equipment and/or as a consequence of the working environment
C. Incident requiring investigation that occurred in relation to NHS funded services and care resulting in; unexpected or avoidable death, permanent harm
D. All of the Above
222. How much urine should someone void an hour?
A. 0.5 – 1ml/Kg/hr of the patient’s body weight
B. 2mls/KG/hr of the patient’s body weight
C. 30mls
D. 50mls
A. 0.5 – 1ml/Kg/hr of the patient’s body weight
B. 2mls/KG/hr of the patient’s body weight
C. 30mls
D. 50mls
223. Patient usually urinates at night Nurse identifies this as:
A. Polyuria
B. Oliguria
C. Nocturia
D. Dysuria
A. Polyuria
B. Oliguria
C. Nocturia
D. Dysuria
224.
Wendy, 18 years old, was admitted on Medical Ward because of recurrent
urinary tract infection (UTI). She disclosed to you that she had
unprotected sex with her boyfriend on some occasions. You are worried
this may be a possible cause of the infection. How will best handle the
situation?
A. tell her that any information related to her well being will need to be share to the health care team
B. inform her parents about this so she can be advised appropriately
C. keep the information a secret in view of confidentiality
D. report her boyfriend to social services
A. tell her that any information related to her well being will need to be share to the health care team
B. inform her parents about this so she can be advised appropriately
C. keep the information a secret in view of confidentiality
D. report her boyfriend to social services
225. What are the steps for the proper urine collection?
I. Clean meatus with soap and water
II. Catch midstream
III. Dispatch sample to laboratory immediately (within 6 hours)
IV. Ask the patient to void her remaining urine into the toilet or bedpan.
A. I, II and III
B. II, III and IV
C. I, II and IV
D. II and IV
I. Clean meatus with soap and water
II. Catch midstream
III. Dispatch sample to laboratory immediately (within 6 hours)
IV. Ask the patient to void her remaining urine into the toilet or bedpan.
A. I, II and III
B. II, III and IV
C. I, II and IV
D. II and IV
226. On removing your patient’s catheter, what should you encourage your patient to do?
A. Rest & drink 2-3 litres of fluid per day
B. Rest & drink in excess of 5 litres of fluid per day
C. Exercise & drink 2-3 litres of fluid per day
D. Exercise & drink their normal amount of fluid intake
A. Rest & drink 2-3 litres of fluid per day
B. Rest & drink in excess of 5 litres of fluid per day
C. Exercise & drink 2-3 litres of fluid per day
D. Exercise & drink their normal amount of fluid intake
227. When should a penile sheath be considered as a means of managing incontinence?
A. When other methods of continence management have failed
B. Following the removal of a catheter
C. When the patient has a small or retracted penis
D. When a patient requests it
A. When other methods of continence management have failed
B. Following the removal of a catheter
C. When the patient has a small or retracted penis
D. When a patient requests it
228. What is the most important guiding principle when choosing the correct size of catheter?
A. The biggest size tolerable
B. The smallest size necessary
C. The potential length of use of the catheter
D. The build of the patient
A. The biggest size tolerable
B. The smallest size necessary
C. The potential length of use of the catheter
D. The build of the patient
229.
When carrying out a catheterization, on which patients would you use
anaesthetic lubricating gel prior to catheter insertion?
A. Male patients to aid passage, as the catheter is longer
B. Female patients as there is an absence of lubricating glands in the female urethra, unlike the male urethra
C. Male & female patients require anaesthetic lubricating gel
D. The use of anaesthetic lubricating gel is not advised due to potential adverse reactions
A. Male patients to aid passage, as the catheter is longer
B. Female patients as there is an absence of lubricating glands in the female urethra, unlike the male urethra
C. Male & female patients require anaesthetic lubricating gel
D. The use of anaesthetic lubricating gel is not advised due to potential adverse reactions
230. What are the principles of positioning a urine drainage bag?
A. Above the level of the bladder to improve visibility & access for the health professional
B. Above the level of the bladder to avoid contact with the floor
C. Below the level of the patient’s bladder to reduce backflow of urine
D. Where the patient finds it most comfortable
A. Above the level of the bladder to improve visibility & access for the health professional
B. Above the level of the bladder to avoid contact with the floor
C. Below the level of the patient’s bladder to reduce backflow of urine
D. Where the patient finds it most comfortable
231. What would make you suspect that a patient in your care had a urinary tract infection?
A. 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
B. The doctor has requested a midstream urine specimen
C. The patient has a urinary catheter in situ & the patient's wife states that he seems more forgetful than usual
D. The patient has complained of frequency of faecal elimination & hasn't been drinking enough
A. 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
B. The doctor has requested a midstream urine specimen
C. The patient has a urinary catheter in situ & the patient's wife states that he seems more forgetful than usual
D. The patient has complained of frequency of faecal elimination & hasn't been drinking enough
232.
A client with frequent urinary tract infections asks the nurse how she
can prevent the reoccurrence. The nurse should teach the client to:
A. Void every three hours
B. Douche after intercourse
C. Obtain a urinalysis monthly
D. Wipe from back to front after voiding
A. Void every three hours
B. Douche after intercourse
C. Obtain a urinalysis monthly
D. Wipe from back to front after voiding
233.
A patient is prescribed metformin 1000mg twice a day for his diabetes.
While taking with the patient he states 'I never eat breakfast so I take
½ tablet at lunch and a whole tablet at supper because I don’t want my
blood sugar to drop.' As his primary care nurse you:
A. Tell him he has made a good decision and to continue
B. Tell him to take a whole tablet with lunch and with supper
C. Tell him to skip the morning dose and just take the dose at supper
D. Tell him to take one tablet in the morning and one tablet in the evening as ordered.
A. Tell him he has made a good decision and to continue
B. Tell him to take a whole tablet with lunch and with supper
C. Tell him to skip the morning dose and just take the dose at supper
D. Tell him to take one tablet in the morning and one tablet in the evening as ordered.
234.
The nurse is caring for a diabetic patient and when making rounds,
notices that the patient is trembling and stating they are dizzy. The
next action by the nurse would be:
A. Administer patient’s scheduled Metformin
B. Give the patient a glass of orange juice
C. Check the patient’s blood glucose
D. Call the doctor
A. Administer patient’s scheduled Metformin
B. Give the patient a glass of orange juice
C. Check the patient’s blood glucose
D. Call the doctor
235. Common signs and symptoms of hypoglycaemia exclude:
A. Feeling hungry
B. Sweating
C. Anxiety or irritability
D. Ketoacidosis
A. Feeling hungry
B. Sweating
C. Anxiety or irritability
D. Ketoacidosis
236. Hypoglycaemia in patients with diabetes is more likely to occur when the patients take:
I. Insulin
II. Sulphonylureas
III. Prandial glucose regulators
IV. Metformin
A. I only
B. III only
C. I and IV only
D. I, II, III
I. Insulin
II. Sulphonylureas
III. Prandial glucose regulators
IV. Metformin
A. I only
B. III only
C. I and IV only
D. I, II, III
237. What are the contraindications for the use of the blood glucose meter for blood glucose monitoring?
A. The patient has a needle phobia and prefers to have a urinalysis.
B. If the patient is in a critical care setting, staff will send venous samples to the laboratory for verification of blood glucose level.
C. If the machine hasn't been calibrated
D. If peripheral circulation is impaired, collection of capillary blood is not advised as the results might not be a true reflection of the physiological blood glucose level.
A. The patient has a needle phobia and prefers to have a urinalysis.
B. If the patient is in a critical care setting, staff will send venous samples to the laboratory for verification of blood glucose level.
C. If the machine hasn't been calibrated
D. If peripheral circulation is impaired, collection of capillary blood is not advised as the results might not be a true reflection of the physiological blood glucose level.
238. What would you do if a patient with diabetes and peripheral neuropathy requires assistance cutting his toenails?
A. Document clearly the reason for not cutting his toe nails and refer him to a chiropodist.
B. Document clearly the reason for not cutting his nails and ask the ward sister to do it.
C. Have a go and if you run into trouble, stop and refer to the chiropodist.
D. Speak to the patient's GP to ask for referral to the chiropodist, but make a start while the patient is in hospital.
A. Document clearly the reason for not cutting his toe nails and refer him to a chiropodist.
B. Document clearly the reason for not cutting his nails and ask the ward sister to do it.
C. Have a go and if you run into trouble, stop and refer to the chiropodist.
D. Speak to the patient's GP to ask for referral to the chiropodist, but make a start while the patient is in hospital.
239.
For an average person from the UK who has non-insulin dependent
diabetes, how many servings of fruits and vegetables per day should they
take?
A. 1 serving
B. 3 servings
C. 5 servings
D. 7 servings
A. 1 serving
B. 3 servings
C. 5 servings
D. 7 servings
240. Common causes for hyperglycaemia include (3 answers):
A. Not eating enough protein
B. Eating too much carbohydrate
C. Over-treating a hypoglycaemia
D. All of the Above
A. Not eating enough protein
B. Eating too much carbohydrate
C. Over-treating a hypoglycaemia
D. All of the Above
241.
Most of the symptoms are common in both type1 and type 2 diabetes.
Which of the following symptom is more common in typ1 than type2?
A. Thirst
B. Weight loss
C. Poly urea
D. Ketones
A. Thirst
B. Weight loss
C. Poly urea
D. Ketones
242.
Alone, metformin does not cause hypoglycaemia (low blood sugar).
However, in rare cases, you may develop hypoglycaemia if you combine
metformin with:
A. a poor diet
B. strenuous exercise
C. excessive alcohol intake
D. All of the Above
A. a poor diet
B. strenuous exercise
C. excessive alcohol intake
D. All of the Above
243.
The nurse is caring for a diabetic patient and when making rounds,
notices that the patient is trembling and stating they are dizzy. The
next action by the nurse would be:
A. Administer patient’s scheduled Metformin
B. Give the patient a glass of orange juice
C. Check the patient’s blood glucose
D. Call the doctor
A. Administer patient’s scheduled Metformin
B. Give the patient a glass of orange juice
C. Check the patient’s blood glucose
D. Call the doctor
244.
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 post-test assessment.
B. Allowing patient’s time to voice their opinions.
C. Providing a snack with a low glycaemic index.
D. Utilizing a variety of educational materials.
A. Administering a pre- and post-test assessment.
B. Allowing patient’s time to voice their opinions.
C. Providing a snack with a low glycaemic index.
D. Utilizing a variety of educational materials.
245.
Mr Cross informed you of how upset he was when you commented on his
diabetic foot during your regular home visit. He is considering seeing
another tissue viability nurse. How will you best respond to him?
A. Apologise for the comments made
B. Tell him of his overreaction
C. Explain that his condition will make him over-sensitive to a lot of things
D. Apologise and tell him to deal with the event lightly
A. Apologise for the comments made
B. Tell him of his overreaction
C. Explain that his condition will make him over-sensitive to a lot of things
D. Apologise and tell him to deal with the event lightly
246. Which of the following indicates the patient needs more education when doing capillary sampling to check for blood sugar?
A. Prick tip of index finger
B. Prick sides of a finger
C. Rotates sites of fingers
D. Use the thumb to draw blood
A. Prick tip of index finger
B. Prick sides of a finger
C. Rotates sites of fingers
D. Use the thumb to draw blood
247.
The client with a history of diabetes insipidus is admitted with
polyuria, polydipsia, and mental confusion. The priority intervention
for this client is:
A. Measure the urinary output.
B. Check the vital signs.
C. Encourage increased fluid intake.
D. Weigh the client
A. Measure the urinary output.
B. Check the vital signs.
C. Encourage increased fluid intake.
D. Weigh the client
248.
You are preparing to consider a Tuberculin (Mantoux) skin test to a
client suspected of having TB. The nurse knows that the test will reveal
which of the following?
A. How long the client has been infected with TB
B. Active TB infection
C. Latent TB infection
D. Whether the client has been infected with TB bacteria
A. How long the client has been infected with TB
B. Active TB infection
C. Latent TB infection
D. Whether the client has been infected with TB bacteria
249. How do we handle a specimen container labelled with a yellow hazard sticker?
A. Wear gloves and apron and inform the laboratory that you are sending the specimen
B. Wear gloves and apron, mark it high risk and send the specimen to the laboratory with your other specimens
C. Wear gloves and apron, inform the infection control team and complete a datix form
D. Wear gloves and apron, place specimen in a blue bag & complete a datix form
A. Wear gloves and apron and inform the laboratory that you are sending the specimen
B. Wear gloves and apron, mark it high risk and send the specimen to the laboratory with your other specimens
C. Wear gloves and apron, inform the infection control team and complete a datix form
D. Wear gloves and apron, place specimen in a blue bag & complete a datix form
250. When collecting an MSU from a male patient, what should they do prior to the specimen being collected?
A. Clean the meatus and catch a specimen from the last of the urine voided
B. Clean the meatus and catch a specimen from the first stream of urine (approx. 30mls)
C. Clean the meatus and catch a specimen of the urine midstream
D. Ask the patient to void into a bottle and pour urine specimen into the specimen container.
A. Clean the meatus and catch a specimen from the last of the urine voided
B. Clean the meatus and catch a specimen from the first stream of urine (approx. 30mls)
C. Clean the meatus and catch a specimen of the urine midstream
D. Ask the patient to void into a bottle and pour urine specimen into the specimen container.
251. How do you ensure the correct blood to culture ratio when obtaining a blood culture specimen from an adult patient?
A. Collect at least 10 mL of blood
B. Collect at least 5 mL of blood.
C. Collect blood until the specimen bottle stops filling.
D. Collect as much blood as the vein will give you
A. Collect at least 10 mL of blood
B. Collect at least 5 mL of blood.
C. Collect blood until the specimen bottle stops filling.
D. Collect as much blood as the vein will give you
252.
If blood is being taken for other tests, and a patient requires
collection of blood cultures, which should come first to reduce the risk
of contamination?
A. Inoculate the aerobic culture first
B. Take the other blood tests first.
C. Inoculate the anaerobic culture first.
D. The order does not matter as long as the bottles are clean
A. Inoculate the aerobic culture first
B. Take the other blood tests first.
C. Inoculate the anaerobic culture first.
D. The order does not matter as long as the bottles are clean
253.
Which of the following techniques is advisable when obtaining a urine
specimen in order to minimize the contamination of a specimen?
A. Clean around the urethral meatus prior to sample collection and get a midstream/clean catch urine specimen.
B. Clean around the urethral meatus prior to sample collection and collect the first portion of urine as this is where the most bacteria will be.
C. Do not clean the urethral meatus as we want these bacteria to analyse as well.
D. Dip the urinalysis strip into the urine in a bedpan mixed with stool
A. Clean around the urethral meatus prior to sample collection and get a midstream/clean catch urine specimen.
B. Clean around the urethral meatus prior to sample collection and collect the first portion of urine as this is where the most bacteria will be.
C. Do not clean the urethral meatus as we want these bacteria to analyse as well.
D. Dip the urinalysis strip into the urine in a bedpan mixed with stool
254. When dealing with a patient who has a biohazard specimen, how will you ensure proper disposal? Select which does not apply:
A. the specimen must be labelled with a biohazard
B. the specimen must be labelled with danger of infection
C. it must be in a double self-sealing bag
D. it must be transported to the laboratory in a secure box with a fastenable lid
A. the specimen must be labelled with a biohazard
B. the specimen must be labelled with danger of infection
C. it must be in a double self-sealing bag
D. it must be transported to the laboratory in a secure box with a fastenable lid
255. What action would you take if a specimen had a biohazard sticker on it?
A. Double bag it, in a self-sealing bag, and wear gloves if handling the specimen.
B. Wear gloves if handling the specimen, ring ahead and tell the laboratory the sample is on its way.
C. Wear goggles and underfill the sample bottle.
D. Wear appropriate PPE and overfill the bottle.
A. Double bag it, in a self-sealing bag, and wear gloves if handling the specimen.
B. Wear gloves if handling the specimen, ring ahead and tell the laboratory the sample is on its way.
C. Wear goggles and underfill the sample bottle.
D. Wear appropriate PPE and overfill the bottle.
256. How do we handle a specimen container labelled with a yellow hazard sticker?
A. Wear gloves and apron and inform the laboratory that you are sending the specimen.
B. Wear gloves and apron, mark it high risk and send the specimen to the laboratory with your other specimens
C. Wear gloves and apron, Inform the infection control team and complete a datix form.
D. Wear gloves and apron, place specimen in a blue bag & complete a datix form
A. Wear gloves and apron and inform the laboratory that you are sending the specimen.
B. Wear gloves and apron, mark it high risk and send the specimen to the laboratory with your other specimens
C. Wear gloves and apron, Inform the infection control team and complete a datix form.
D. Wear gloves and apron, place specimen in a blue bag & complete a datix form
257. You are caring for a patient who is known to have dementia. What particular issues should you consider prior to discharge.
A. You involve in his care: Independent Mental Capacity Advocacy Service (Mental Capacity Act 2005)
B. You involve other support services in his discharge: The hospital discharge team, social services, the metal health team
C. Admit the patient into a care home
D. Have the patient's family take full responsiblity
A. You involve in his care: Independent Mental Capacity Advocacy Service (Mental Capacity Act 2005)
B. You involve other support services in his discharge: The hospital discharge team, social services, the metal health team
C. Admit the patient into a care home
D. Have the patient's family take full responsiblity
258.
Which of the following is a guiding principle for the nurse in
distinguishing mental disorders from the expected changes associated
with aging?
A. A competent clinician can readily distinguish mental disorders from the expected changes associated with aging
B. Older people are believed to be more prone to mental illness than young people
C. The clinical presentation of mental illness in older adults differs form that in other age groups
D. When physical deterioration becomes a significant feature of an elder’s life, the risk of comorbid psychiatric illness arises.
A. A competent clinician can readily distinguish mental disorders from the expected changes associated with aging
B. Older people are believed to be more prone to mental illness than young people
C. The clinical presentation of mental illness in older adults differs form that in other age groups
D. When physical deterioration becomes a significant feature of an elder’s life, the risk of comorbid psychiatric illness arises.
259. A normal sign of aging in the renal system is
A. Intermittent incontinence
B. Concentrated urine
C. Microscopic hematuria
D. A decreased glomerular filtration rate
A. Intermittent incontinence
B. Concentrated urine
C. Microscopic hematuria
D. A decreased glomerular filtration rate
260.
A 76 year old man who is a resident in an extended care facility is in
the late stages of Alzheimer’s disease. He tells his nurse that he has
sore back muscles from all the construction work he has been doing all
day. Which response by the nurse is most appropriate?
A. “ you know you don’t work in construction anymore”
B. “What type of motion did you do to precipitate this soreness?”
C. “You’re 76 years old & you’ve been here all day. You don’t work in construction anymore.”
D. “Would you like me to rub your back for you?”
A. “ you know you don’t work in construction anymore”
B. “What type of motion did you do to precipitate this soreness?”
C. “You’re 76 years old & you’ve been here all day. You don’t work in construction anymore.”
D. “Would you like me to rub your back for you?”
261. How should be the surrounding area of a patient with dementia?
A. Increased stimuli
B. Creative environment
C. Restrict activities
D. Decreased stimuli
A. Increased stimuli
B. Creative environment
C. Restrict activities
D. Decreased stimuli
262.
An 86 year old male with senile dementia has been physically abused
& neglected for the past two years by his live in caregiver. He has
since moved & is living with his son & daughter-in-law. Which
response by the client’s son would cause the nurse great concern?
A. How can we obtain reliable help to assist us in taking care of Dad? We can’t do it alone.
B. Dad used to beat us kids all the time. I wonder if he remembered that when it happened to him?
C. I’m not sure how to deal with Dad’s constant repetition of words.
D. I plan to ask my sister & brother to help my wife & me with Dad on the weekends.
A. How can we obtain reliable help to assist us in taking care of Dad? We can’t do it alone.
B. Dad used to beat us kids all the time. I wonder if he remembered that when it happened to him?
C. I’m not sure how to deal with Dad’s constant repetition of words.
D. I plan to ask my sister & brother to help my wife & me with Dad on the weekends.
263.
Knowing the difference between normal age-related changes &
pathologic findings, which finding should the nurse identify as
pathologic in a 74 year old patient?
A. Increase in residual lung volume
B. Decrease in sphincter control of the bladder
C. Increase in diastolic BP
D. Decreased response to touch, heat & pain.
A. Increase in residual lung volume
B. Decrease in sphincter control of the bladder
C. Increase in diastolic BP
D. Decreased response to touch, heat & pain.
264. Which of the following is a behavioural risk factor when assessing the potential risks of falling in an older person?
A. Poor nutrition/fluid intake
B. Poor heating
C. Foot problems
D. Fear of falling
A. Poor nutrition/fluid intake
B. Poor heating
C. Foot problems
D. Fear of falling
265. What medications would most likely increase the risk for fall?
A. Loop diuretic
B. Hypnotics
C. Betablockers
D. Nsaid
A. Loop diuretic
B. Hypnotics
C. Betablockers
D. Nsaid
266. Among the following drugs, which does not cause falls in an elderly?
A. Diuretics
B. NSAIDS
C. Beta blockers
D. Hypnotics
A. Diuretics
B. NSAIDS
C. Beta blockers
D. Hypnotics
267.
Mr Bond, 72 years old, complains of difficulty of chewing his food. He
normally wears upper dentures daily. On assessment, you noticed some
signs of gingivitis. Which of the following signs will you expect?
A. redness of soft palate and tissues surrounding the teeth
B. haemo-serous discharges around the gums
C. loosening of teeth
D. presence of pockets deep in the gums
A. redness of soft palate and tissues surrounding the teeth
B. haemo-serous discharges around the gums
C. loosening of teeth
D. presence of pockets deep in the gums
268.
Mr Bond also shared with you that his gums also bleed during brushing.
Which of the following statement will best explain this?
A. lack of vitamin C in his diet
B. he is brushing too hard
C. he is not using proper toothbrush to remove the plaque
D. he is flossing wrongly
A. lack of vitamin C in his diet
B. he is brushing too hard
C. he is not using proper toothbrush to remove the plaque
D. he is flossing wrongly
269. What are the principles of communicating with a patient with delirium?
A. Use short statements and closed questions in a well lit, quiet, familiar environment.
B. Use short statements and open questions in a 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 and closed questions.
A. Use short statements and closed questions in a well lit, quiet, familiar environment.
B. Use short statements and open questions in a 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 and closed questions.
270. Why is pyrexia not evident in the elderly?
A. Due to lesser body fat
B. Due to immature T cells
C. Due to aged hypothalamus
D. Due to biologic changes
A. Due to lesser body fat
B. Due to immature T cells
C. Due to aged hypothalamus
D. Due to biologic changes
271. Which of the following is a sign of dehydration in the elderly?
A. diminished skin turgor
B. hypertension
C. anxiety attacks
D. pyrexia
A. diminished skin turgor
B. hypertension
C. anxiety attacks
D. pyrexia
272.
In a community hospital, an elderly man approaches you and tells you
that his neighbour has been stealing his money, saying 'sometimes I give
him money to buy groceries but he didn't buy groceries and he kept the
money'. What is your best course of action for this?
A. Raise a safeguarding alert
B. Just listen but don't do anything
C. Ignore the old man, he is just having delusions
D. Refer the old man to the community clergy who is giving him spiritual support
A. Raise a safeguarding alert
B. Just listen but don't do anything
C. Ignore the old man, he is just having delusions
D. Refer the old man to the community clergy who is giving him spiritual support
273. Which is not an appropriate way to care for patients with Dementia/Alzheimer’s?
A. Ensure people with dementia are excluded from services because of their diagnosis, age, or any learning disability.
B. Encourage the use of advocacy services and voluntary support
C. Allow people with dementia to convey information in confidence.
D. Identify and wherever possible accommodate preferences (such as diet, sexuality and religion).
A. Ensure people with dementia are excluded from services because of their diagnosis, age, or any learning disability.
B. Encourage the use of advocacy services and voluntary support
C. Allow people with dementia to convey information in confidence.
D. Identify and wherever possible accommodate preferences (such as diet, sexuality and religion).
274. Barbara, an elderly patient with dementia, wishes to go out of the hospital. What will be your appropriate action?
A. Call the police, make sure she does not leave
B. Encourage the patient to stay for his well being
C. Inform the police to arrest the patient
D. Allow her to leave, she is stable and not at risk of anything
A. Call the police, make sure she does not leave
B. Encourage the patient to stay for his well being
C. Inform the police to arrest the patient
D. Allow her to leave, she is stable and not at risk of anything
275. Conditions producing orthostatic hypotension in the elderly:
A. Aortic stenosis
B. Arrhythmias
C. Diabetes
D. All of the above
A. Aortic stenosis
B. Arrhythmias
C. Diabetes
D. All of the above
276.
An 83-year old lady just lost her husband. Her brother visited the lady
in her house. He observed that the lady is acting okay but it is
obvious that she is depressed. 3 weeks after the husband's death, the
lady called her brother crying and said that her husband just died. She
even said, 'I can't even remember him saying he was sick.' When the
brother visited the lady, she was observed to be well physically but was
irritable and claims to have frequent urination at night and she
verbalizes that she can see lots of rats in their kitchen. Based on the
manifestations, as a nurse, what will you consider as a diagnosis to
this patient?
A. urinary tract infection leading to delirium
B. delayed grieving with dementia
C. simple bereavement
D. acute psychosis due to loss
A. urinary tract infection leading to delirium
B. delayed grieving with dementia
C. simple bereavement
D. acute psychosis due to loss
277.
Angel, 52 years old lose her husband due to some disease. 4 weeks
later, she calls her mother and says that, 'yesterday my husband died…I
didn’t know that he was sick…I can't sleep and I see rats and mites in
the kitchen.' What is Angel’s condition?
A. She can't adjust without her husband
B. Late grievance with signs of dementia
C. Alzheimer's with delirium
D. Acute stress reaction
A. She can't adjust without her husband
B. Late grievance with signs of dementia
C. Alzheimer's with delirium
D. Acute stress reaction
278. Why are elderly prone to postural hypotension? Select which does not apply:
A. The baroreflex mechanisms which control heart rate and vascular resistance decline with age.
B. Because of medications and conditions that cause hypovolaemia.
C. Because of less exercise or activities.
D. Because of a number of underlying problems with BP control.
A. The baroreflex mechanisms which control heart rate and vascular resistance decline with age.
B. Because of medications and conditions that cause hypovolaemia.
C. Because of less exercise or activities.
D. Because of a number of underlying problems with BP control.
279. Why should healthcare professionals take extra care when washing and drying an elderly patient's skin?
A. As the older generation deserve more respect and tender loving care (TLC).
B. As the skin of an elder person has reduced blood supply, is thinner, less elastic and has less natural oil. This means the skin is less resistant to shearing forces and wound healing can be delayed.
C. All elderly people lose dexterity and struggle to wash effectively so they need support with personal hygiene.
D. As elderly people cannot reach all areas of their body, it is essential to ensure all body areas are washed well so that the colonization of Gram-positive and negative micro-organisms on the skin is avoided.
A. As the older generation deserve more respect and tender loving care (TLC).
B. As the skin of an elder person has reduced blood supply, is thinner, less elastic and has less natural oil. This means the skin is less resistant to shearing forces and wound healing can be delayed.
C. All elderly people lose dexterity and struggle to wash effectively so they need support with personal hygiene.
D. As elderly people cannot reach all areas of their body, it is essential to ensure all body areas are washed well so that the colonization of Gram-positive and negative micro-organisms on the skin is avoided.
280. Why is pyrexia not always evident in the elderly?
A. Due to immature T cells
B. Due to mature T cells
C. Due to immature D cells
D. Due to mature D cells
A. Due to immature T cells
B. Due to mature T cells
C. Due to immature D cells
D. Due to mature D cells
281. Why constipation occurs in old age?
A. Anorexia and weight loss
B. Decreased muscle tone and peristalsis
C. Increased mobility
D. Increased absorption in colon
A. Anorexia and weight loss
B. Decreased muscle tone and peristalsis
C. Increased mobility
D. Increased absorption in colon
282.
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.
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.
283.
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 assess her when she gets home
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 assess her when she gets home
284.
You are looking after a 75 year old woman who had an abdominal
hysterectomy 2 days ago. What would you do to 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
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
285.
Fiona a 70 year old has recently been diagnosed with type 2 diabetes.
You have devised a care plan to meet her nutritional needs. However, you
have noted that she has poor fitting dentures. Which of the following
is the least likely risk to the service user?
A. Malnutrition
B. Hyperglycemia
C. Dehydration
D. Hypoglycemia
A. Malnutrition
B. Hyperglycemia
C. Dehydration
D. Hypoglycemia
286. What is the most common cause of hypotension in elderly?
A. Decreased response in adrenaline & noradrenaline
B. Atheroma changes in vessel walls
C. hyperglycaemia
D. Age
A. Decreased response in adrenaline & noradrenaline
B. Atheroma changes in vessel walls
C. hyperglycaemia
D. Age
287. What is an intermediate care home?
A. It is the day-to-day health care given by a health care provider.
B. It includes a range of short-term treatment or rehabilitative services designed to promote independence.
C. It is a system of integrated care.
D. It is a means of organising work, that is patient allocation.
A. It is the day-to-day health care given by a health care provider.
B. It includes a range of short-term treatment or rehabilitative services designed to promote independence.
C. It is a system of integrated care.
D. It is a means of organising work, that is patient allocation.
288. What is not included in the care package in a nursing home?
A. Laundry
B. Food
C. Nursing Care
D. Social Activities
A. Laundry
B. Food
C. Nursing Care
D. Social Activities
289.
The nurse cares for an elderly patient with moderate hearing loss. The
nurse should teach the patient’s family to use which of the following
approaches when speaking to the patient?
A. Raise your voice until the patient is able to hear you.
B. Face the patient and speak quickly using a high voice.
C. Face the patient and speak slowly using a slightly lowered voice.
D. Use facial expressions and speak as you would formally.
A. Raise your voice until the patient is able to hear you.
B. Face the patient and speak quickly using a high voice.
C. Face the patient and speak slowly using a slightly lowered voice.
D. Use facial expressions and speak as you would formally.
290.
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. What's
your best action?
A. Discuss with the manager that task-oriented nursing may ruin the holistic care that we provide here in this tertiary level.
B. Ask the manager to re-consider the time bound, make sure that all staffs are informed about task oriented nursing care
C. Agree to comply without question
D. Organize a staff meeting to discuss new protocols on care delivery
A. Discuss with the manager that task-oriented nursing may ruin the holistic care that we provide here in this tertiary level.
B. Ask the manager to re-consider the time bound, make sure that all staffs are informed about task oriented nursing care
C. Agree to comply without question
D. Organize a staff meeting to discuss new protocols on care delivery
291. A patient with dementia is mourning and pulling the dress during the night. What do you understand from this?
A. Patient is incontinent
B. Patient is having pain
C. Patient has medication toxicity.
D. Patient is experiencing anxiety
A. Patient is incontinent
B. Patient is having pain
C. Patient has medication toxicity.
D. Patient is experiencing anxiety
292.
An elderly client with dementia is cared by his daughter. The daughter
locks him in a room to keep him safe when she goes out to work and not
considering any other options. As a nurse what is your action?
A. Explain this is a restrain. Urgently call for a safe guarding and arrange a multi-disciplinary team conference
B. Do nothing as this is the best way of keeping him safe
C. Call police, social services to remove client immediately and refer to safeguarding
D. Explain this is a restrain and discuss other possible options
A. Explain this is a restrain. Urgently call for a safe guarding and arrange a multi-disciplinary team conference
B. Do nothing as this is the best way of keeping him safe
C. Call police, social services to remove client immediately and refer to safeguarding
D. Explain this is a restrain and discuss other possible options
293.
In a community setting, an elderly patient reported to you that he
gives shopping money to his neighbours but failed to bring groceries on
frequent occasions. What is your best response on this situation?
A. Confront the neighbour
B. Ignore, maybe he is very old and does not think clearly
C. Fill up a raising a concern/ safeguarding form, and escalate
D. Ask patient to report neighbour to police
A. Confront the neighbour
B. Ignore, maybe he is very old and does not think clearly
C. Fill up a raising a concern/ safeguarding form, and escalate
D. Ask patient to report neighbour to police
294. Which of the following displays the proper use of Zimmer frame?
A. using a 1 point gait
B. using a 2 point gait
C. using a 3 point gait
D. using a 4 point gait
A. using a 1 point gait
B. using a 2 point gait
C. using a 3 point gait
D. using a 4 point gait
295.
The client advanced his left crutch first followed by the right foot,
then the right crutch followed by the left foot. What type of gait is
the client using?
A. Swing to gait
B. Three point gait
C. Four point gait
D. Swing through gait
A. Swing to gait
B. Three point gait
C. Four point gait
D. Swing through gait
296. Nurse is teaching patient about crutch walking which is incorrect?
A. Take long strides
B. Take small strides
C. Instruct to put weight on hands
D. Maintain a steady grip on crutches
A. Take long strides
B. Take small strides
C. Instruct to put weight on hands
D. Maintain a steady grip on crutches
297.
After instructing the client on crutch walking technique, the nurse
should evaluate the client's understanding by using which of the
following methods?
A. Have client explain produce to the family
B. Achievement of 90 on written test
C. Rationale
D. Return demonstration
A. Have client explain produce to the family
B. Achievement of 90 on written test
C. Rationale
D. Return demonstration
298.
A nurse is caring for a patient with canes. After providing instruction
on proper cane use, the patient is asked to repeat the instructions
given. Which of the following patient statement needs further
instruction?
A. ‘The hand opposite to the affected extremity holds the cane to widen the base of support & to reduce stress on the affected limb.’
B. as the cane is advanced, the affected leg is also moved forward at the same time
C. ‘when the unaffected extremity begins the swing phase, the client should bear down on the cane’
D. To go up the stairs, place the cane & affected extremity down on the step. Then step down the unaffected extremity
A. ‘The hand opposite to the affected extremity holds the cane to widen the base of support & to reduce stress on the affected limb.’
B. as the cane is advanced, the affected leg is also moved forward at the same time
C. ‘when the unaffected extremity begins the swing phase, the client should bear down on the cane’
D. To go up the stairs, place the cane & affected extremity down on the step. Then step down the unaffected extremity
299.
Nurses assume responsibility on patient with cane. Which of the
following is the nurse’s topmost priority in caring for a patient with
cane?
A. Mobility
B. Safety
C. Nutrition
D. Rest periods
A. Mobility
B. Safety
C. Nutrition
D. Rest periods
300. To promote stability for a patient using walkers, the nurse should instruct the patient to place his hands at:
A. The sides of the walker
B. The hips
C. The hand grips
D. The tips
A. The sides of the walker
B. The hips
C. The hand grips
D. The tips
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