Test Instructions

Please do not write on these question sheets. You will be given a separate sheet to
write your answers down. You will be given a total of four hours to complete the test.
Please hand in your question sheets and answer sheet to the invigilator when you
have completed the test and/or have used the allocated time.

Set B- Test of Competency- Part 1 (Theory /Computer based Test)

1. The Nursing and Midwifery Council (NMC) regulates the nursing and
midwifery practice for England, Wales, Scotland and Northern Ireland and the
Islands. Which of the following is not part of their function?
a. safeguard the health and well-being of the public
b. ensure that nurses and midwives keep their skills and knowledge up to
date and uphold the standards of their professional code
c. have fair processes to investigate allegations made against nurses and
midwives who may not have followed the code
d. coordinates with Department of Health in formulating delivering strategic
national policies

2. As a nurse, the people in your care must be able to trust you with their health
and wellbeing. In order to justify that trust, you must not:
a. Work with others to protect and promote the health and wellbeing of those
in your care
b. Provide a high standard of practice and care when required
c. Always act lawfully, whether those laws relate to your professional practice
or personal life.
d. Be personally accountable for actions and omissions in your practice

3. The NMC expects every nurse and midwife to demonstrate commitment to

personal and professional development. Which of the following action will best
help you achieve this?
a. Evaluation
b. Reflection
c. Both
d. Neither

4. An enquiry was launched involving a death of one of your patient. The police
visited your unit to investigate. When interviewed, which of the following
framework will best help you assist the investigation:
a. Data Protection Act 2005
b. Storage of Records Policy
c. Consent Policy
d. Confidentiality Guidelines

5. Consent is best defined as:

a. Obtaining consent is a process and is a one-off event
 b. Valid consent must be given by a competent person (who may be a
person lawfully appointed on behalf of the person) and must be given
voluntarily
c. Another person can give consent for an adult who has the capacity to
consent
d. The assessment as to whether an adult lacks the capacity to consent or
not is primarily down to the clinician providing the treatment or care but
nurses and midwives have no responsibility to participate in discussions
about this assessment

6. Your patient is for home discharge tomorrow after a hip replacement. You
found out that he lives alone in a warden-controlled flat and will require a
zimmer frame in mobilising. Which of the following will you do next?
a. Complete and send off Section 2 of discharge plan
b. Complete and send off Section 5 of discharge plan
c. Inform the family of his condition and needs after discharge
d. Inform the social worker to liaise with the warden of his condition

7. Mr. Jones’ carers approach you to express their dissatisfaction with the care
he is receiving whilst under your care. How will you best approach this
situation?
a. Explain to them that evidence should be made explicit to move the case
forward
b. tell them to put their complaint forward to the nurse-in-charge or sister of
the ward
c. advise them to speak to the police if a case needs to be filed
d. apologise to them and reassure that their concerns will be dealt with in
accordance to policy

8. When nurses and midwives are considering which tasks and activities to
delegate they should consider the following except:
a. the needs of the people in their care
b. the unexpected outcome of the delegated task
c. the availability of resources to meet those needs
d. the judgment of the nurse or midwife

9. As a registered nurse, you are accountable to the following except:

a. Public
b. Profession
c. Employer
d. Media

10. Which statement best describes duty of care?

a. Reasonable care taken to avoid acts/omissions likely to cause harm
b. As a registered nurse or midwife, you are accountable for your own
actions and omissions
 c. A competent adult has the legal right to refuse treatment, even if that
refusal will adversely affect his or her health or shorten his or her life
d. None

11. Case scenario

Mr Smith had been experiencing episodes of abdominal pain and was

admitted for further investigation into these episodes. He had previously
been treated for gastric ulcers. You have been caring for him for 2 days
now. He is prescribed oral paracetamol 1 gram every 6 hours and was left
on his table for him to take when able. You have noticed no improvement
on his pain and decided to phone the doctor for advise. Dr Quinn gave a
verbal order of oral diclofenac 50 mg which you promptly administered.
After an hour, Mr Smith pain worsened and vomited frank blood. His vital
signs were not good and you have asked a nursing assistant to phone the
doctor again.

12. Based on the scenario, which of the following actions contravenes safe
medicine administration?
a. Leaving drugs unattended by patients bed side
b. Taking a ‘verbal prescription’ over the phone
c. Administering a NSAID to a patient with a history of gastric ulcers
d. All

13. In the above scenario, what was the harm caused?

a. Patient’s condition deteriorated
b. Patient’s analgesia was not effective
c. Nurse did not inform the doctor early
d. Nursing assistant got involved in the care of patient

14. Medication error accounts for around a quarter of the incidents that threaten
patient safety. In a study published in 2000 it was found that 10% of all
patients admitted to hospital suffer an adverse event (incident). How much of
these incidents were preventable?
a. 20 %
b. 30 %
c. 50 %
d. 60 %

15. Introducing measures to reduce error without knowing about specific

problems is still a challenging issue in the healthcare profession. To maintain
patient safety, address faults in the system and procedures and enable
professionals to learn from mistakes, as a nurse you should:
a. Report medication errors
 b. Cover up medication errors at the first instance and report on the
succeeding event
c. Send person who made the error to training to give them a chance to
improve
d. Refer erring person to manager for capability assessment and
performance management

16. The NMC Code expects nurses to safeguarding the health and wellbeing of
the public through the use of best available evidence in practice. Which of the
following nursing actions will ensure this?
a. Using isopropyl alcohol 70% to wipe skin prior to cannulation
b. suggesting healthcare products or services that are still trialled
c. ensure that the use of complementary or alternative therapies is safe and
in the best interests of those in your care
d. All

17. Registrants must only supply and administer medicinal products in

accordance with one or more of the following processes, except:
a. Carer specific direction (CSD)
b. Patient medicines administration chart (may be called medicines
administration record MAR)
c. Patient group direction (PGD)
d. Medicines Act exemption

18. Mental Capacity Act 2005 explores which of the following concepts?
a. Mental capacity, advance treatment decisions, and the act’s code of
practice
b. Mental capacity, independent mental capacity advocates, and the act’s
code of practice
c. Mental capacity, advance treatment decisions, independent mental
capacity advocates, and the act’s code of practice
d. Mental capacity and the possible ethical and legal dilemmas in its
interpretation

19. Which of the following actions will best support a nurse treating individuals
with respect and dignity?
a. Not actively identify people who are discriminating
b. Treat people’s confidentiality with reservation
c. collaborate with those in your care only when asked to
d. not asking for or accepting loans from anyone
20. The patients, colleagues, families and carers expect the nurse to
demonstrate the following actions, except:
a. take responsibility for the care they provide and answer for their own
judgements and actions
b. manage and be vigilant about risk
c. lead by example
d. maintain confidentiality and dignity only as requested

21. You are doing an assessment of a patient with darky pigmented skin. Which
of the following can help detect early signs of pressure damage?
a. Colour may differ from surrounding area
b. Not possible to detect with this kind of skin pigmentation
c. Presence of spots on affected area
d. Loss of sensation on the affected area

22. You were asked to classify the pressure ulcer developed by one of your
patient under your care. You cannot determine the true depth due to the
slough or eschar which needed to be removed to expose the base of the
wound. You will classify this as:
a. Category 2 to 3
b. Category 1 to 2
c. Category 3 to 4
d. Unable to classify

23. Repositioning is one of the intervention used to help relieve pressure ulcer
and its development. Which of the following will not help achieve this?
a. pressure relieving mattresses and cushions
b. 30 degree tilt
c. turning chart
d. move patient when convenient

24. Which of the following should NOT be used to help relieve pressure? Select
all that apply.
a. air mattress
b. donut shape devices
c. water filled gloves
d. foam mattress

25. As a registered nurse, you are expected to practice in a holistic, non-

judgmental, caring and sensitive manner. Which of the following situations
demonstrate this?
a. A relative of a patient informed of a quiet room to pray
b. Ensuring a halal-prepared food to an Imam
 c. A vulnerable adult examined and assessed by a doctor with another
member of staff
d. A expectant teenage mother asked not to have her boyfriend present in
the delivery room due to bad behaviour allegations

26. In order to promote an environment of care that is culturally sensitive, free

from discrimination, harassment and exploitation, as a nurse, you should act:
a. Autonomously and professionally
b. Proactively and autonomously
c. Proactively and professionally
d. Independently and autonomously

27. Individuals have the right to dignity, humanity and equality in all settings.
Which of the following legislation does not support this?
a. The Human Rights Act 1998
b. Equality Act 2010
c. Medicine Management Act
d. Mental Capacity Act

28. A 37 year-old woman presented in Accident and Emergency accompanied by

her husband due to swollen wrist. On your assessment, you noticed some
bruises over the arm upon rolling her sleeves. She looks reserved and only
replies to your questions in short answers. When her husband left to see their
children, she becomes extremely nervous and showing signs of restlessness.
You suspected some safeguarding issues but she would not give much
information when probed. What will be your next appropriate action?
a. Make a safeguarding referral on behalf of the woman and her children as
you suspect domestic violence
b. Inform nurse-in-charge about your suspicion and refer when appropriate
c. Alert the police on the safety of the woman’s children
d. Refer the husband to the Council for social work assessment and
investigation on suspicion of violence against women and children

29. Which of the following local agencies have a responsibility to investigate and
take action when a vulnerable adult is believed to be suffering abuse?
a. commissioners of health and social care services
b. the police and other relevant law enforcement agencies (including the
Crown Prosecution Service)
c. agencies offering legal advice and representation
d. Department of Health

30. Which of the following is not considered to be a vulnerable adult?

a. John, a student nurse with dyslexia living with his working class parents
b. Cherry, a Down’s syndrome at Respite Care
c. Steve, a jobless adult sleeping roughly in street
 d. Grace, a single-mother of two kids with history of domestic violence from
previous relationship

31. Over half the population think the elderly aren't treated with enough dignity
and respect in hospitals and nursing homes, according to a survey. In which
of the following nursing actions does not demonstrate dignity and respect?
a. identify people who are discriminating
b. respect people’s confidentiality
c. assisting physiotherapist in mobilising the patient
d. refusing to accept monies given by relatives

32. John is now the main carer for his wife Marsha who has Multiple Sclerosis.
Marsha is now supported by a ventilator in intensive care unit and the
chances of her recovering is very low and the doctors discussed with him the
situation. He wanted to end Marsha’s suffering. How would you best support
John on this situation?
a. Allow John time to comprehend information received before making the
decision
b. Assess John’s coping strategies and supplement when required
c. Talk to John about where and when to get support at this time to help him
with his decision
d. Tell John to let natural process of dying end Marsha’s suffering

33. One of your patient is for lobectomy because of lung cancer asks if he can
still continue with his smoking after the operation. What is your best response
to him?
a. Smoking is a major contributing factor to lung disease and will affect
recovery time
b. His recovery is upon him whether he smokes or not
c. There are various factors that will affect recovery after surgery and
smoking could be one of them
d. The cancerous part of the lung had been removed so it will be ok to
continue smoking

34. John, 25 year old, was admitted at Medical Assessment Unit because of urine
infection. During your assessment, he admitted using cannabis under
prescription for his migraine and still have some in his bag. What is your best
reply to him about the cannabis?
a. Cannabis is a class C drug under the UK Misuse of Drugs Act 1971
b. A custodial sentence of 28 days is now given to anyone in possession 3
times or more
c. Cannabis is a class B drug under the UK Misuse of Drugs Act 1971
d. Possession of cannabis will incur a penalty of 3 months imprisonment with
£2000 fine
35. Colin, 65 year old, had been discharged home because of Parkinson’s
Syndrome. He is the main carer of her wife with early stage dementia. They
live in a warden controlled flat. As their named visiting public health nurse,
how will you ensure their safety?
a. Ask the warden to regularly visit the couple
b. Do a risk assessment
c. Refer to social worker for additional support
d. Increase frequency of visit

36. Colin is aware about the impact of his Parkinson’s Syndrome on their lives as
a couple but refuse additional support when offered. At this stage, you will:
a. Respect his wishes and ensure support is available
b. Assess his mental capacity
c. Seek local council’s support to safeguard them
d. Ask living relatives who may help explain the need for support

37. An allegation was made by Colin against the community nurse who
inappropriately touching her wife with dementia. He made a complaint through
the Patient Experience Team at the Primary Care Trust. His complaint is
reviewed for any potential safeguarding issues in the period within:
a. 24 hours
b. 2 days
c. 7 days
d. 2 weeks

38. Safeguarding is best described as:

a. A range of activity aimed at upholding a person’s right to be safe
b. Important to people who are able to keep themselves safe
c. It is the main responsibility of the service user and their carers
d. All

39. You are the named nurse of Colin admitted at Respiratory ward because of
chest infection. His also suffers from Parkinson’s syndrome. What
medications will you ensure Colin has taken on regular time to control his
‘shaking’?
a. Co-careldopa (Sinemet)
b. Co-amoxiclav (augmentin)
c. Co-codamol
d. Co-Q10

40. The on-call physiotherapist responded to your referral regarding Colin’s

mobility and chest infection. She asked you about his cough and breathing
effort. What is your best response to her?
a. “I do not know. Please do an independent assessment”
b. “He is wheezy and have given him nebuliser. Please reinforce breathing
and coughing exercises.”
c. “He coughs and breathes ok. Your assessment will help and guide us to
deal with his condition.”
d. “You are the expert. Please let me know.”
41. One of the relative wishes to visit a patient in isolation room because of
suspected clostridium difficile. Which of the following personal protective
equipment (PPE) will you ask him to don?
a. Plastic apron and mask
b. Plastic apron, mask and gloves
c. Plastic apron only
d. Plastic apron and gloves

42. 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 defined 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

43. You are working at an acute medical unit (AMU) for a month now after
receiving your NMC registration. Lynda, the bed manager of the day who
previously worked in AMU, wanted to you to admit a surgical patient who is
breaching the four-hour wait in Accident and Emergency (A&E). How will you
best respond to her?
a. Refuse to Lynda’s request as AMU can only admit patients with medical
conditions
b. Admit the patient as he is breaching the waiting time to prevent getting
penalised by the government
c. Seek the nurse-in-charge’s advise and inform Lynda of decision
d. Admit the patient and request for a nurse from surgical ward to care for the
patient

44. Rosie, the physiotherapist, was on the Respiratory ward to see the patients
referred to her over the weekend. Which among the following patients will you
ask Rosie to see first?
a. John, non-compliant with spirometry exercises
b. Josh, wheezy due to asthma and currently nebulising
c. Jack, short of breath due to thick and copious phlegm
d. Jill, coughing on and off due to flu

45. Which of the following patient information will you provide Rosie to help her in
doing her job?
a. Drug allergies
b. Admission diagnosis
c. Social history
d. All
46. Upon assessment, your patient has high risk to develop pressure ulcer
because of his nutrition. Which of the following best describes this
relationship?
a. a lack of appetite leads to patient becoming sensitive to certain food
b. lack of energy results in reduced mobility
c. it can affect tissue integrity which increases risk
d. all

47. You are nearing the end of your preceptorship period and your line manager
set up a meeting to conduct a mini-appraisal. What is the main rationale for
this?
a. Establish if objectives set were met and formulate new goals to help in
personal and professional development
b. Check compliance with policies and guidelines
c. Knowing your performance and get criticisms
d. all

48. Immediately after the lumbar tab procedure, the patient complained of
headache with some dizzy episodes. What is your next action to do at this
time?
a. Encourage the patient to stay lying flat on his bed for at least 6 hours
b. Check site for any leakage of blood or fluid
c. Monitor vitals signs and add NEWS score
d. Call the doctor to assess the patient

49. One of your patient in a bay 1 is having episodes of vomiting in the last 2 days
now. The norovirus alert has been enforced. The other patients looked
concerned that he may spread infection. What is your next action on this
situation?
a. Seek the infection control nurse’s advise regarding isolation
b. Give the patient antiemetic to control the vomiting
c. Offer the patient a lot of drinks to rehydrated
d. Tell the other patients that vomiting will not cause infection to others

50. One of your patient has challenged your recent practice of administering a
subcutaneous low-molecular weight heparin (LMWH) without disinfecting the
injection site. The guidelines for nursing procedures do not recommend this
method. Which of the following response will support your action?
a. “We were taught during our training not to do so as it is not based on
evidence.”
b. “Our guidelines, which are based on current evidence, recommends a
non-disinfection method of subcutaneous injection.”
c. “I am glad you called my attention. I will disinfect your injection site next
time to ensure your safety and peace of mind.”
d. “Disinfecting the site for subcutaneous injection is a thing of the past. We
are in an evidence-based practice now.”
51. Which of the following statements does not illustrate evidence-based practice
(EBP)?
a. the conscientious, explicit and judicious use of current best evidence in
making decisions about the care of individual patients
b. integrating individual clinical expertise with the best available external
clinical evidence from systematic research
c. a difficult and time-consuming task but is not an essential skill in
implementing change in practice
d. the reliability of evidence is essential to guide clinicians in establishing its
effectiveness in clinical practice

52. One of your patient was pleased with the standard of care you have provided
him. As a gesture, he is giving you a £50 voucher to spend. What is your most
appropriate action on this situation?
a. Accept the voucher and thank him for this gesture
b. Refuse the voucher and thank him for this gesture
c. Accept the voucher and give it to ward manager
d. Refuse the voucher and inform the ward manager for his gesture

53. Mr Cross informed you of how upset he was when you commented on his
diabetic foot during your regular home visit. He is considering to see 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

54. Barbara, a 75-year old patient from a nursing home was admitted on your
ward because of fractured neck of femur after a trip. She will require an open-
reduction and internal fixation (ORIF) procedure to correct the injury. Which of
the following statements will help her understand the procedure?
a. You are going to have an ORIF done to correct your fracture.
b. Some metal screws and pins will be attached to your hip to help with the
healing of your broken bone.
c. The operation will require a metal fixator implanted to your femur and
adjacent bones to keep it secured
d. The ORIF procedure will be done under general anaesthesia by an
orthopaedic surgeon

55. Barbara was screaming in pain later in the day despite the PCA in-situ. You
refer back to your nurse in charge for a stronger pain killers. She refused to
call the doctor because her pain relief was reassessed earlier. What will you
do next?
a. Continue to refer back to her until she calls the doctor
b. Encourage Barbara to continuously use the PCA
c. Give Barbara some sedatives to keep her calm
d. Wait until her pain stops
56. Joanne, a staff nurse at a urological ward, approached the bedside of Carl, to
empty his catheter bag. When doing the task, which of the following actions
will Carl expect from Joanne to demonstrate?
a. Greet him, explain the task, empty the bag and document the output
b. Smile at him, empty the bag and document the output
c. Empty the bag and document the output
d. Explain the task , empty the bag and document the output

57. After the rounds, Carl would like to get more involved in his care. As his
nurse, how will you demonstrate support on him?
a. Encourage him to ask questions during rounds
b. Coach him when making decisions
c. Use jargons and abbreviations when explaining
d. Provide updates to relatives as needed

58. Barbara, an elderly patient on your ward, was a head teacher in secondary
school before her retirement. She commented on how caring, compassionate,
empathetic and kind the nursing staff members are. Which of the following
nursing statements will have demonstrated these?
a. “ I do understand now why you behaved that way, Barbara. I can still learn
from you.”
b. “I am helping because I want to get this job done now so I can go for my
break.”
c. “Barbara, you need to finish your food within 20 minutes. I still need to give
your nebulisers.”
d. “People are different at work. I choose who I can relate and work well
with.”

59. Later on in your shift, Barbara was seen arguing with another patient across
the bay and she is becoming quite abusive verbally. What is you initial
response to manage the situation?
a. Ask who started the argument
b. Tell both they are upset and offer help to manage the situation
c. Remove Barbara from the scene
d. Call the security

60. Barbara was discharged on your ward after 7 days. Before she went home,
she left a thank you card with a box of chocolates as a gesture of appreciation
to the care she have received. What is most appropriate response to her?
a. Thank her for the kind gesture
b. Return the chocolates but keep the card
c. Refuse the card and the chocolates
d. Ask her to feedback to patient experience team

61. Lisa, a working mother of 3, has approached you during a recent attendance
of her daughter in Accident and Emergency because of an acute asthma
attack about smoking cessation. What is your most appropriate response to
her?
a. Smoking cessation will help prevent further asthma attack
b. Referral can be made to the local NHS Stop smoking service
 c. Discuss with her the NICE recommendations on smoking cessation
d. It is not common for people like her to stop smoking

62. Jenny, a nursing assistant working with you in an Elderly Care Ward is
showing signs of norovirus infection. Which of the following will you ask her to
do next?
a. Go home and avoid direct contact with other people and preparing food for
others until at least 48 hours after her symptoms have disappeared
b. Disinfect any surfaces or objects that could be contaminated with the virus
c. Flush away any infected faeces or vomit in the toilet and clean the
surrounding toilet area
d. Avoid eating raw oysters

63. Your patient has been prescribed Tramadol 50 mgs tablet for pain relief.
Upon receipt of the tablets from the pharmacist you will:
a. Record this in the controlled drug register book with the pharmacist
witnessing
b. Put it in the patient’s medicine pod
c. Store it in ward medicine cupboard
d. Ask the pharmacist to give it to the patient

64. Your ward has been working on ways to improve the nutrition status of all
patients with dementia. Which action will best help you achieve this?
a. Ask relatives to bring food that patient likes most
b. Update the nutrition risk assessment sheet regularly
c. Provide each patient with supplemental high caloric drinks
d. Assign a nursing assistant to help feed the patients

65. Barbara, a dementia patient has suffered a mild stroke whilst under your care.
She has been given a red tray to remind others her need of assistance in
feeding. How will you ensure she gets the required assistance needed?
a. Check the food chart every meal times
b. Allocate a member of staff to assist her during meal times
c. Ask relative not to visit during meal times
d. Ask the patient if someone has helped her during meal times

66. Steve, was admitted to your ward after sustaining a head injury following a
fight with another fan during a football match. One of the police officer has
asked you if he can access his medical records. You will:
a. Allow the police officer to read through his medical notes
b. Ask the police officer to obtain a warrant
c. Refer the police officer to the nurse-in-charge
d. Ask the police officer to seek the patient’s consent

67. Which of the following is considered acceptable for nurses to do when sharing
information?
a. discuss matters related to the people in their care during break times
b. discuss a case with colleagues in public lift or elevator
c. leave records at patient bed space
 d. give telephone updates only to patient’s next of kin

68. Barbra’s friend Colin is enquiring about her condition over the phone. As her
named nurse, you will keep confidentiality by:
a. Providing him with the information he needs
b. Asking him to speak to Barbara’s relative for information
c. Gaining Barbara’s consent to provide him information
d. Asking Barbara to speak to him

69. You are the sign-off mentor of Ben, a third year nursing student. Your ward is
his last clinical area placement. When caring for a patient with diarrhoea who
uses the commode, you will expect him to:
a. Use alcohol gel to clean his hands before and after care
b. Wash his hands with soap and water before and after care
c. Clean the commode with soap and water
d. Clean the commode with triclosan solution

70. An Ebola Preparedness Training was highlighted during your ward meeting.
Which of the following people will you get involve to deliver the training within
your nursing team?
a. Consultant Anaesthetist
b. Locum Microbiologist
c. Infection Control Specialist Nurse
d. Clinical Nurse Practitioner

71. After 4 weeks on your ward, Barbara was ready to be discharged home and
will require wound dressing change of her healing heels. Which among the
following people will you get involve in changing her dressings at home?
a. Tissue viability nurse
b. Social worker
c. Community nurse
d. Occupational therapist

72. Gary, 87 years old resident at your nursing care home was upset when his
relatives went home immediately after their visit to attend to an emergency.
You saw him looking outside the window and crying. How will you provide
support to him?
a. “Gary, do you want something to drink?”
b. “Everything will be fine. I am sure they will visit you again next weekend.”
c. “Gary, are you ok? Do you want me to stay with you?”
d. “I can phone them to come back, if that will help you.”

73. A complaint was made by Sonia, daughter Sylvia, an elderly and confused
resident in your nursing care home when you replied rudely to her. Your
nurse-in-charge is doing an investigation to gather facts. Later on in your shift,
you saw Sonia feeding Sylvia during the protected meal time. As her named
nurse, you will:
a. Ask Sonia to leave as visiting time is over
b. Encourage Sonia to stay to help with feeding
c. Watch Sylvia feeds her mother
 d. Report Sonia’s feeding technique to nurse-in-charge

74. Barry who suffers from heart failure would like to know why he needs a
diuretic. Your best response is:
a. Diuretics will help heart muscles pump regularly.
b. Diuretics help maintain regular heart rhythm.
c. Diuretics help eliminate excess fluid in the body.
d. Diuretics help ease breathing effort.

75. Dennis was admitted because of acute asthma attack. Later on in your shift,
he complained of abdominal pain and vomited. He asked for pain relief. Which
of the following prescribed analgesia will you given him?
a. Fentanyl buccal patch
b. Ibuprofen enteric coated capsule
c. Paracetamol suppositories
d. Oromorphine

76. You were asked by the nursing assistant to see Claudia whom you have
recently given trimetophrim 200 mgs PO because of urine infection. When
you arrived at her bedside, she was short of breath, wheezy and some red
patches evident over her face. Which of the following actions will you do if you
are suspecting anaphylaxis?
a. Call for help and give oxygen
b. Give oxygen and salbutamol nebs if prescribed and call for help
c. Give oxygen, administer adrenaline 500 mcg IM, give salbutamol nebs if
prescribed and call for help
d. Call for help, give oxygen, administer adrenaline 500 mcg IM, give
salbutamol nebs if prescribed

77. You have asked Sean, a third year nursing student, to take the vital signs of
Mr Derby and report it back to you. Mr Derby is 1 day post-operative hernia
repair. Which of the following report will indicate that Sean has received
support in doing his assessment?
a. “Mr Derby feels dizzy when standing up so I checked his breathing if it is
ok.”
b. “His blood pressure is slightly high. His pain is moderate on movement.
Some analgesia will help him.”
c. “Mr Derby’s wound dressing is slightly soaked with blood. We need to
change it now to prevent infection.”
d. “His vital signs are all normal. He does not show any signs of
complication.”

78. You went back to see Mr Derby who is 1 day post-herniorraphy. As you
approached him he complained of difficulty of breathing with respiration rate
of 23 breaths per minute and oxygen saturation 92% in room air. What is your
next action to help him?
a. Give him oxygen
b. Give him pain relief
c. Give him antibiotics
 d. Give him nebulisers

79. Delia, 60 year old lady was recently diagnosed with Type 2 Diabetes. She
wanted to do her own blood sugar testing and monitoring. How will you help
her achieve this?
a. refer Delia to the Diabetic Nurse
b. demonstrate how the machine works
c. assess her compliance
d. tell her she will be taught before discharge

80. Which of the following documents will help you demonstrate providing an
accurate and comprehensive written report of your care based on best
possible evidence?
a. integrated care pathway sheet
b. handover sheet
c. NEWS chart
d. wound chart

81. Mrs Clay reported to you that she is feeling unwell. She is admitted because
of exacerbation of her COPD. Her vital signs showed the following:
Respiration rate- 16 breaths per minute
SpO2- 94% on 2 liters oxygen via nasal cannula
BP- 100/50 mmHg
Pulse- 106 beats per minute, weak and thread
Blood sugar- 5.1 mmols/L
Which of the following action will you do next?
a. keep her comfortable by sitting upright
b. call the doctor
c. reassess for any deterioration
d. encourage her to do deep breathing exercise

82. The infection control nurse phoned and reported to you the following results of
the samples taken from four patient in Bay A- one of the patient was tested
positive for MRSA; another was tested positive for clostridium difficile; and the
remaining two were negative for both. Your ward have 1 isolation room only.
What action will you do?
a. put patient with c-diff in isolation room
b. put patient with MRSA in isolation room
c. transfer the two patients who are negative to both infections to another bay
d. keep them all in the same bay but reinforce strict hand washing

83. The use of alcohol hand rub is only encouraged when:

a. hands are visibly clean
b. hands are dirty
c. washing sink is not available
d. donning off soiled gloves

84. Adam, a local Rabbi, was admitted because of patellar fracture. His operation
had been cancelled. He had fasted for 8 hours and now wanted to eat. You
showed him the hospital menu. Which of the following food will he prefer?
 a. a lamb kebab with sautéed mixed vegetables
b. a kosher prepared braised beef with roast potatoes
c. a spicy chicken tikka masala
d. a vegan dish

85. Vindhu, an elderly lady in your nursing care home is not eating much because
she misses her husband who recently passed away. As you weigh her, she
had lost 4 lbs in the last 2 weeks. How will you best support her to get her
back to her previous weight?
a. advise her to eat all her food at meal times
b. ask her to take food supplements
c. discuss food choices in the menu
d. encourage to help in cooking

86. Diana, 17 years old, an aspiring glamour model will be discharged home 2
days after she was rushed to Accident and Emergency following a fainting
episode. Her discharge summary notes read “hypoglycaemia secondary to
poor dietary intake”. She is worried that it could happen again? How will you
best reply to her?
a. “You are fine now. It won’t happen again.”
b. “You fainted because of low sugar in your blood. You should eat and drink
at regular intervals.”
c. “Your wrong diet caused this problem. You need to eat healthy food.”
d. “Being fit and healthy will need eating the right food.”

87. Your hospital supports the government’s drive on breastfeeding. One of your
patient being treated for urinary tract infection was visited by her husband and
their 4 month old baby. She would like to breastfeed her baby. What advise
will you give her?
a. it is ok to breastfeed as long as it is done privately
b. it is ok to breastfeed because the hospital supports this practice
c. refrain from breastfeeding as of now because of her UTI treatment
d. breast milk is the best and she can feed her baby anytime they visit

88. Louise, a second year student nurse, is on placement on your medical ward.
She has been coughing and sneezing as the shift started. Few hours later,
she reported to you that she is not feeling well. What is your next course of
action?
a. send her home
b. offer her an early break
c. ask her to drink plenty of fluids
d. give her some medicines for cough

89. Which of the following actions will demonstrate support to a patient’s human
rights?
a. ask preferred name at the start of shift
b. two nurses talking about their planned vacation whilst giving a patient a
bath
c. doctor talking about patient A’s diagnosis in a bay full of other patients
 d. a close neighbour of patient visited and updates given by nurse when
sought by them

90. Which of the following is not considered to be a medical device?

a. prefilled syringe with 0.9%l saline solution
b. hoist
c. ward weighing machine
d. bedpan

91. Mr Connor responded well to his nasogastric tube (NGT) feeding and will
continue for 3 more days at a constant rate of 80 ml/hr until the next review by
the dietician. Evidence-based practice suggests that to keep its patency,
flushing is needed to be done:
a. every 8 hours
b. every 12 hours
c. every 24 hours
d. only as required

92. Mr James’s IV cannulae is in-situ for 3 days now and showing no signs of
abnormality. The visual inspection of phlebitis(VIP) form recommends:
a. removal and re-site if requires
b. can still be used up 5 days
c. consider removal and re-site if requires
d. can still be used up to 4 days

93. 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. aseptic non-touch technique
c. medical asepsis
d. dip-tip technique

94. Whilst cleaning Mr Connor’s neck wound, you accidentally dropped a used
piece of surgical gauze (swab). The nursing assistant offered to disposed of it
and clean the area. Which of the following will you ask him to use when
cleaning the area?
a. use a mop, soap and water
b. use a clinical wipes with detergent
c. use clinical wipes with alcohol
d. use a mop with chloroprep solution

95. You are assisting a doctor inserting a central line. After the procedure, he
asked your help by disposing of the tray with some used needles. You will:
a. dispose of the tray
b. decline to his request
c. ask another person to do it for him
d. tell him it is his responsibility to dispose of it
96. Mr Connor is prescribed oromorph 10 mgs every 6 hours. The drug is suppled
in a concentration of 5 mgs per 2 mls. How much will you give him for a single
dose?
a. 4 mls
b. 8 mls
c. 6 mls
d. 10 mls

97. Which of the following drugs will require 2 nurses to check during preparation
and administration?
a. oral antibiotics
b. glycerine suppositories
c. morphine tablet
d. oxygen

98. Which of the following nursing actions demonstrate safe medicine

management principles?
a. asking a nursing assistant to give oral laxatives to an elderly patient
b. allowing a final placement nursing student giving paracetamol tablet
unsupervised
c. checking an IV antibiotic with a pharmacist
d. checking a controlled drug with a medical student

99. A nursing assistant would like to know what a patient group directive means.
Your best reply will be:
a. they are specific written instructions for the supply and administration of a
licensed named medicine
b. can be used by any registered nurse or midwife caring for the patient
c. drugs can be used outside the terms of their licence (“off label”),
d. it is an alternative form of prescribing

100. Which of the following people is not exempted from paying a

prescribed medication?
a. children under the age of 16
b. women of child bearing age
c. people who are receiving support allowance
d. pensioners of age 65 and above

101. One of your patient on chemotherapy approached and asked you of

ways to cope with and manage its side effects. How will you provide support
to him?
a. tell him that side effects are normal and expected
b. encourage to use some techniques like distraction and relaxation
c. ask him to take the medicines as prescribed
d. encourage him to have a good rest before and after the chemotherapy

102. Barbara, a frail lady who lives alone with her cat, was brought in A&E
via ambulance after a neighbour found her lying in front of her house. No
doctor is available to see her immediately. Barbara told you she is worried
about her cat who is alone in the house. How will you best reply to her?
 a. “You should worry about yourself and not the cat.”
b. “Your cat sounded like very dear to you. Can I ask your neighbour to
check.”
c. “Do you want me to see you cat also? I cannot do that now.”
d. “Your cat can look after itself, I am sure.”

103. After 2 hours in A and E, Barbara is now ready to be moved to another

ward. You went back to tell her about this plan and noticed she was not
responding. What is your next action as a priority?
a. assess for signs of life
b. shout for help
c. perform CPR
d. keep her airway open

104. Doris is a 75-year old lady admitted on your ward because of chest
infection is slowly making progress. Whilst doing your routine risk
assessment, you have noticed a significant decrease in her weight. As her
named nurse, what is your next action?
a. ask a dietician to review her
b. give bigger portions of food at meal time
c. provide her with supplementary drinks
d. ask her relative to help feed her during mealtimes

105. When doing your drug round at midday, you have noticed one of your
patient coughing more frequently whilst being assisted by a nursing student at
mealtime. What is you initial action at this situation?
a. tell the student to feed the patient slowly to help stop coughing
b. ask the student to completely stop feeding
c. ask student to allow patient some sips of water to stop coughing
d. ask student to stop feeding and assess patients swallowing

106. You have taken over the care of Mrs Clarke from Jenny, outgoing night
nurse. During your initial assessment, you noticed that the patient’s current IV
drip does not match with the prescription on the drug chart. What will be your
action on this situation?
a. call the night nurse and ask why she put up a drip different from what was
prescribed
b. fill out an incident report of the observed discrepancy
c. change the IV drip as per prescription and ask night nurse to sign later
d. report the night nurse to the manager for the error made

107. Rob, 44 year old man with multiple sclerosis was visited by his wife in
the morning whilst you are doing your routine hygiene rounds. He would like
her assistance with his hygiene needs. As his named nurse, you will:
a. allow his wife to assist
b. tell him that his hygiene needs will be met faster if it was done by you
c. refuse his request as you are busy and his wife may get into your way
d. ask a nursing assistant to assist Rob as his wife is a visitor
108. Johnny still refused to have a catheter inserted despite numerous
strategies attempted to gain his consent. He promised to let you know of what
he drink and eat and when he goes to toilet. What will be your next action at
this stage?
a. still do the catheterisation as this is required for his care
b. consider his promise
c. ask a doctor to fill out a consent form for him
d. inform his relative and ask them to convince him to have it done

109. Danni, 70 year old, is a known Type 1 Diabetes and self-administers

own insulin. You would like to assess how safely she can self-administer her
insulin. Which of the following will demonstrate this action?
a. Danni took the novorapid pen. You let her continue without confirming the
dosage.
b. Danni’s blood sugar was 4.0 mmol/L. She injected her insulin anyway.
c. You observed Danni doing the injection without hand hygiene. You allowed
her to continue.
d. Danni re-sheath the needle before throwing it in the sharps bin. You
reminded her of safe disposal techniques.

110. Which if the following actions illustrate your support of your patients’
human rights?
a. Barbara does not want to be washed in the morning as this disturbs her
sleep. Ward staff continue to wash all patients at 7 am.
b. Jenny, of Islam background continue to wear niqab during her stay on your
ward. When needs to be examined, you always arrange for a female
chaperone.
c. Patient has advance directives in place of no invasive procedures and
treatment in event of deterioration. Patient was admitted in intensive care
intubated and ventilated after the cardiac arrest.
d. Patient refused to eat hospital food. You have asked the patient to give a
try.

111. Barbara, a frail lady admitted on your ward because of urine infection
wanders off with an anti-embolic socks on causing her to slip and eventually
fall. How will you keep her safe when mobilising?
a. remove her anti-embolic socks and replace it with non-slip ones
b. refer to physiotherapist for other mobilising support
c. inform Barbara of restricting her mobilisation
d. assign someone to supervise her closely when mobilising

112. You are visiting Mr Clarins in his house to check on his leg cellulitis.
Whilst doing your assessment, he informed you of a positive MRSA swab
result of his legs that was sent by his GP. What will you do on this situation?
a. ask the social services to modify care package immediately
b. document the result on his case notes to flag it up amongst others
c. inform all carers involved in his care about this result
d. do nothing as he has already been aware
113. Mr. Adams, 80 years old with dementia, has been shouting and
swearing in his bed as you start on your night shift. Mr Adams’ daughter was
upset when she found out he was moved to another bay on his own and
wanted to complain. How will you best respond to this situation?
a. it was in his best interest to be moved away from others and she cannot
complain about it
b. tell her the procedure on filing a complaint is a long process
c. refer her to the patient experience team to complain
d. acknowledge her concerns and discuss process on how to complain

114. Your ward team leader sent you to work on another ward because of
staff shortage. As you receive the handover, the doctor asked you to do a
catheterisation on one female patient because she needs to escort an
ambulance transfer. You have always done this procedure with supervision of
a senior colleague and you do not feel confident doing it on your own. What
action will you do?
a. ask the other nurse to do this as you have just started
b. wait for the doctor to come back and perform the procedure with her
supervision
c. act confidently and perform the procedure own your own
d. look for staff who can supervise you doing the procedure

115. You noticed the named consultant of your patient examining him
without wearing the required PPE. What action will you do?
a. allow the consultant to continue examining the patient as it is important
b. ask the consultant to wear the required PPE
c. report the consultant to the ward manager about his behaviour
d. stop the consultant from examining your patient

116. Which of the following ward activities can you participate best as a
ward nurse to improve the safety of your patients?
a. clinical trials
b. clinical audits
c. clinical teaching
d. clinical rotation

117. Your patient’s blood pressure tablet treatment has recently been
changed by her doctor. How will you evaluate the effects of the treatment to
her?
a. check her blood pressure regularly
b. ask patient to document readings of blood pressure
c. take blood samples for analysis
d. do a serial ECG

118. David, 66 years old, was seen and reviewed by the consultant. Some
changes have been made on his treatment plan. How will you best inform
your colleagues of these changes?
a. send them an email
b. ask David to tell everyone when they see him
 c. update handover sheet
d. document on ward’s diary

119. Which of the following illustrates a nurse’s personal prejudices, values

and attitudes did not compromised care to patients?
a. a healthy teenager, 16 years old, was denied of contraception at a sexual
clinic
b. a mother of patient with learning disability allowed to use staff facilities
freely
c. a lesbian couple given advise on birthing delivery methods
d. a husband with history of alcoholism was restricted to visit his wife in ICU

120. Bob is showing early signs of dementia. Which of the following actions
do not show effective use of evidences in caring for him?
a. encourage families and caregivers of a person with dementia to create a
playlist of uniquely meaningful music on an iPod and offer it at any time of the
day or night
b. use aromatherapy as a relaxation method
c. catheterisation during incontinence period
d. giving antipsychotic drugs on time