1. Tom 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 give him?
Fentanyl buccal patch
Ibuprofen enteric coated capsules
Paracetamol suppositories
Oromorphine
2. Which of the following drugs will require 2 nurses to check during preparation and administration?
oral antibiotics
glycerine suppositories
morphine tablet
oxygen
3. Debra has ran out of Cavilon Cream. You have noted that her groins are very red and sore. You can see that David has spare Cavilon tubes after checking the stocks. What will you do?
Borrow a tube from David’s stock as Debra’s groins are red and sore
Use Canesten for now and apply Cavilon once stock has arrived
Request for a repeat prescription from the GP, and have the stock delivered by the chemist
Ring the GP and ask him to see Debra’s groins, then prescribe Cavilon.
4. A patient develops shortness breath after administering 3rd dose of penicillin. The patient is unwell. Your response
Call for help, ensure anaphylaxis pack is available, assess ABC, dnt leave the patient until medical help comes
Assesss ABC, make patient lie flat, reassure and continue observing
5. What is the best position in applying eye medications?
Sitting position with head tilt to the right
Sitting position with head tilt backwards
Prone position with head tilt to the left
6. Mild pain after surgery and pain is reduced by taking which medicine
paracetamol
ibuprofen
paracetamol with codeine
paracetamol with morphine
7. Olivia is on Cefalexin QID. You were working on a night shift and have noticed that the previous nurse has not signed for the last two doses. What should you do?
Document the incident and speak to your Manager
Check the rota, find out when he is back and leave a note on the MARS for him to sign
Find out what the whistle blowing policy is about
Ask the qualified nurse to sign it on handover if it is definitely been administered
8. Select which is not a proper way of Administering Eye Drops?
Administer the prescribed number of drops, holding the eye dropper 1-2 cm above the eye. If the patient links or closes their eye, repeat the procedure
ask the patient to close their eyes and keep them closed for 1-2 minutes
If administering both drops and ointment, administer ointment first
Ask the patient to sit back with neck slightly hyper extended or lie down
9. Adam is also prescribed some medications for his Gout. Which of the following health teaching will you advise him to do?
Increase fluid intake 2 - 3 liters per day
Have enough sunshine
Avoid paracetamol (first line analgesic)
avoid dairy products
10. Which of the following should be considered before giving digoxin?
Allergies
Drug interactions
Other interactions with food or substances like alcohol and tobacco
Medical problems (Thyroid problems, kidney disease, etc.
All of the above.
11. Oral corticosteriods side effect
mood variation
edema
12. What instructions should you give a client receiving oral Antibiotics?
Consume it all at once
take the antibiotic with glass of water
Take the medication with meals and consume all the antibiotics
take the medication as prescribed and complete the course
13. An antihypertensive medication has been prescribed for a client with HTN. The client tells the clinic nurse that they would like to take an herbal substance to help lower their BP. The nurse should take which action?
Tell the client that herbal substances are not safe & should never be used
Teach the client how to take their BP so that it can be monitored closely
Encourage the client to discuss the use of an herbal substance with the health care provider
14. Which of these medications is not administer with digoxin?
Diuretics
Corticosteroids
Antibiotics
NSAID’s
15. Patricia has been prescribed with Estradiol tablet to be inserted twice a week at night. You entered her bedroom and noticed she is fast asleep. What would you do?
Try to gently wake her up and insert her vaginal tablets.
Allow her to get some sleep and try to insert the vaginal tablet on your next turn rounds.
Speak to her and ask her to spread her legs, so you can insert her vaginal tablet.
Document that the tablet cannot be administered at all because the patient has refused.
16. Prothrombin time is essential during anticoagulation therapy. In oral anticoagulation therapy which test is essential?
Activated Thromboplastin Time - The partial thromboplastin time (PTT) test is a blood test that is done to investigate bleeding disorders and to monitor patients taking ananticlotting drug (heparin).
International Normalized Ratio - The Prothrombin time (PT) test, standardised as the INR test is most often used to check how well anticoagulant tablets such as warfarin and phenindione are working
17. Mrs Smith has been very chesty the last few days. She has been having difficulty with breathing. You have referred her to the GP, and requested for a home visit. What would probably be prescribed by the GP?
Stalevo 200
Digoxin 40 mg
Trimethoprim 100 mg
Simvastatin 100 mg
18. John is to receive his eyedrops after his cataract operation. What is the best position for John to assume when instilling the eyedrops?
sitting position, head tilted backwards
supine position for comfort
standing position to facilitate drainage
recovery position
19. Your patient has been prescribed Tramadol 50 mgs tablet for pain relief.
Record this in the controlled drug register book with the pharmacist witnessing
Put it in the patient’s medicine pod
Store it in ward medicine cupboard
Ask the pharmacist to give it to the patient
20. What is not a good route for IM injection?
upper arm
stomach
thigh
buttocks
21. Precise indicator of anticoagulation status when on oral anticoagulants
Ptt
aPTT
ct
INR
22. A patient doesn’t take a tablet which is prescribed by a doc. Nurse should
Inform the incident to senior nurse and ward in charge
Inform pharmacist
Do not inform anybody.routinely chart
23. A patient in your care is on regular oral morphine sulphate. As a qualified nurse, what legal checks do you need to carry out every time you administer it, which are in addition to those you would check for every other drug you administer?
Check to see if the patient has become tolerant to the medication so it is no longer effective as analgesia.
Check to see whether the patient has become addicted.
Check the stock of oral morphine sulphate in the CD cupboard with another registered nurse and record this in the control drug book; together, check the correct prescription and the identity of the patient.
Check the stock of oral morphine sulphate in the CD cupboard with another registered nurse and record this in the control drug book; then ask the patient to prove their identity to you
24. 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?
it is ok to breastfeed as long as it is done privately
it is ok to breastfeed because the hospital supports this practice
refrain from breastfeeding as of now because of her UTI treatment
breast milk is the best and she can feed her baby anytime they visit
25. You are the named nurse of James admitted at Respiratory ward because of chest infection. His also suffers from Parkinson's syndrome. What medications will you ensure James has taken on regular time to control his 'shaking'?
Co-careldopa (Sinemet)
Co-amoxiclave (augmentin)
Co-codamol
Co-Q10
26. The nurse monitors the serum electrolyte level of a client who is taking digoxin. Which of the following electrolytes imbalances is common cause of digoxin toxicity?
Hypocalcemia
Hypomagnesemia
Hypokalaemia
Hyponatremia
27. Which drug to be avoided by a patient on digoxin?
corticosteroid
nsaid
28. A sexually active female , who has been taking oral contraceptives develops diarrohea. Best advice
Advise her to refrain from sex till next periods
Advice to switch to other measures like condoms, as diarrohea may reduce the effect of oral contraceptives
29. All but one are signs of opioid toxicity:
CNS depression (coma)
Pupillary miosis
Respiratory depression (cyanosis)
Tachycardia
30. When should prescribed antibiotics to be administered to a septicemic patient
Immediately after admission
After getting blood culture result
Immediately following blood drawn for culture
31. Mark has a history of Congestive Heart Failure. He has also been complaining of general weakness. After taking his physical observations, you have noticed that he has pitting oedema on both feet. Which of the following is incorrect?
The Water Pill can be prescribed to manage fluid retention.
Lasix can be prescribed for the pitting oedema.
Furosemide and Digoxin can be combined for patients with CHF.
Furosemide will increase Mark’s blood pressure, and lessen pitting oedema.
32. What are the key nursing observations needed for a patient receiving opioids frequently?
Respiratory rate, bowel movement record and pain assessment and score.
Checking the patent is not addicted by looking at their blood pressure.
Lung function tests, oxygen saturations and addiction levels
Daily completion of a Bristol stool chart, urinalysis, and a record of the frequency with which the patient reports breakthrough pain
33. Boris, 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 cannibis?
Cannibis is a class C drug under the UK Misuse of Drugs Act 1971.
A custodial sentence of 28 days i s now given to anyone in possession 3 times or more
Cannabis is a class B drug under the UK Misuse of Drugs Act 1971
Possession of cannabis will incur a penalty of 3 months imprisonment with £2 000 fine
34. After two weeks of receiving lithium therapy, a patient in the psychiatric unit becomes depressed. Which of the following evaluations of the patient’s behavior by the nurse would be MOST accurate?
The treatment plan is not effective; the patient requires a larger dose of lithium.
This is a normal response to lithium therapy; the patient should continue with the current treatment plan.
This is a normal response to lithium therapy; the patient should be monitored for suicidal behavior.
The treatment plan is not effective; the patient requires an antidepressant
35. When the doc will prescribe a broad-spectrum antibiotic?
on admission
when septicemia is suspected
when the blood culture shows positive growth of organism
36. You are caring for a Hindu client and it’s time for drug administration; the client refuses to take the capsule referring to the animal product that might have been used in its making, what is the appropriate action for the nurse to perform?
She will not administer and document the ommissions in the patients chart
The nurse will ignore the clients request and administer forcebily
The nurse will open the capsule and administer the powdered drug
The nurse will establish with the pharamacist if the capsule is suitable for vegetarians
37. A patient is prescribed metformin 1000mg twice a day for his diabetes. While talking with the patient he states “I never eat breakfast so I take a % 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:
Tell him hehas made a good decision and to continue
Tell him to take a whole tablet with lunch and with supper
Tell him to skip the morning dose and just take the dose at supper
Tell him to take one tablet in the morning and one tablet in the evening as ordered
38. You are the named nurse of Mr Bond who has just undergone an abdominal surgery 4 hours ago. You have administered his regular analgesia 2 hours ago and he is still complaining of pain. Your most immediate, most appropriate nursing action?
call the doctor
assist patient in a comfortable position
give another dose
look for a heating pad
39. A patient was on morphine at hospital. On discharge doctor prescribes fentanyl patches. At home patient should be observed for which sign of opiate toxicity?
Shallow, slow respiration, drowsiness, difficulty to walk, speak and think
Rapid, shallow respiration, drowsiness, difficulty to walk, speak and think
Rapid wheezy respiration, drowsiness, difficulty to walk, speak and think
40. You have been asked to give Mrs Smith her mid-day oral metronidazole. You have never met her before. What do you need to check on the drug chart before you administered?
Her name and address, the date of the prescription and dose.
Her name, date of birth, the ward, consultant, the dose and route, and that it is due at 12.00.
Her name, date of birth, hospital number, if she has any known allergies, the prescription for metronidazole: dose, route, time, date and that it is signed by the doctor, and when it was last given
Her name and address, date of birth, name of ward and consultant, if she has any known allergies specifically to penicillin, that prescription is for metronidazole: dose, route, time, date and that it is signed by the doctor, and when it was last given and who gave it so you can check with them how she reacted.
41. What fluid should ideally be used when irrigating eyes?
sterile 0.9% sodium chloride
Sterile water
Chloramphenicol drops
tap water
42. A Ibuprofen 200mg tablet has been prescribed. You only have a 400mg coated ibuprofen tablet. What should you do?
Give half of the tablet
crush the tablet and give half of the amount
order the different dose of tablet from pharmacy
omit
43. What could be the reason why you instruct your patient to retain on its original container and discard nitroglycerine meds after 8 weeks?
removing from its darkened container exposes the medicine to the light and its potency will decrease after 8 weeks
it will have a greater concentration after 8weeks
44. On which step of the WHO analgesic ladder would you place tramadol and codeine?
Step 1: Non Opioid Drugs
Step 2: Opioids for Mild to Moderate Pain
Step 3: Opioids for Moderate to Severe Pain
Herbal medicine
45. Tim is in persistent pain and has Oromorph PRN. All your carers are on their rounds, and you are about to administer this drug. What would you do?
Dispense 10 mL Oromorph and administer immediately to relieve pain
Dispense 10 mL Oromorph and call one of the carers to witness
Call one of the carers to witness dispensing and administering the drug
Administer the drug and ask one of the carers to sign the book after their pad rounds
46. How should eye drops be administered?
Pulling on the lower eyelid and administering the eye drops
Pulling on the upper eyelid and administering the eye drops
Tip the patients head back and administer the eye drops into the cornea
Tip the patients head to the side and administer the eye drops into the nasolacrimal system
47. Mr Smith has been having Type 6 and 7 stools today. As you are doing his medications, which of the following would you not omit?
Docusate Sodium 2 Capsules
Lactulose 5 mL
Senna 10 mL
Simvastation 100 mg
48. Mark, 18 years old is for discharge and will require further dose of oral antibiotics. As his nurse, which of the following will you advise him to do?
Take with food or after meals and ensure to take all antibiotics as prescribed
Take all antibiotics and as prescribed
Take medicine during the day and ensure to finish the course of medication
Take medicine and stop when he feels better
49. You are the night nurse in a nursing home. Mary, 81 years old, has been prescribed with Lorazepam PRN. You have assessed her to be wandering and talking to staff. When do you administer the Lorazepam?
Immediately due to wandering
As soon as possible so she can go to bed
When you see signs of confusion
When you see signs of agitation
50. Describe the breathing pattern when a patient is suffering from Opioid toxicity: