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RCSI NMBI Aptitude Test study materials
RCSI NMBI Aptitude Test study resources

RCSI NMBI Aptitude Test practice questions

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Question 1Professional and ethical nursing practice

Which ethical principle supports a nurse respecting a competent patient's decision to decline a recommended treatment?

  1. Non-maleficence
  2. Autonomy Correct answer.
  3. Beneficence
  4. Justice

Explanation

Autonomy is the principle that a person has the right to make informed decisions about their own care, even where the nurse disagrees with the choice. The other principles guide beneficial action, avoidance of harm and fair distribution of resources.

Question 2Professional and ethical nursing practice

A nurse arranges additional pain relief and comfort measures for a patient in severe pain. Which ethical principle is being demonstrated?

  1. Justice
  2. Beneficence Correct answer.
  3. Veracity
  4. Autonomy

Explanation

Beneficence is the duty to act in ways that benefit the patient, such as relieving pain and promoting comfort. It requires the nurse to weigh potential benefits against risks.

Question 3Professional and ethical nursing practice

A nurse checks a patient's allergy status before administering an antibiotic. Which ethical principle does this primarily reflect?

  1. Autonomy
  2. Justice
  3. Non-maleficence Correct answer.
  4. Fidelity

Explanation

Non-maleficence is the duty to avoid causing harm, and checking allergy status prevents a foreseeable harmful reaction. It is often expressed as 'first, do no harm'.

Question 4Professional and ethical nursing practice

A nurse manager must allocate a limited number of specialist beds. Which principle guides fair and equitable distribution based on clinical need?

  1. Veracity
  2. Justice Correct answer.
  3. Autonomy
  4. Beneficence

Explanation

Justice requires fair and equitable distribution of scarce resources, with decisions based on clinical need and consistent criteria rather than personal preference. It applies at both individual and organisational levels.

Question 5Professional and ethical nursing practice

A patient's neighbour, who is not involved in the patient's care, asks a nurse for an update on the patient's condition. What is the most appropriate response?

  1. Decline, as information cannot be shared without consent Correct answer.
  2. Provide details because the neighbour is concerned
  3. Refer the neighbour to the patient's chart
  4. Give a brief general update to reassure the concerned neighbour

Explanation

Patient information is confidential and may be shared only with the patient's consent, when required by law, or with those directly involved in care on a need-to-know basis. A neighbour has no right of access.

Question 6Professional and ethical nursing practice

Which element is essential for valid informed consent?

  1. A relative signs the consent form on the patient's behalf
  2. The nurse withholds information that may upset the patient
  3. The patient receives information on risks and alternatives Correct answer.
  4. Consent is obtained after the procedure is completed

Explanation

Valid consent requires the patient to have capacity, to receive sufficient information about risks, benefits and alternatives, and to decide voluntarily before the procedure. Withholding information undermines informed consent.

Question 7Professional and ethical nursing practice

A patient with early dementia is unable to weigh up the risks of a proposed procedure. What is the nurse's most appropriate action?

  1. Proceed because the patient attended the appointment
  2. Ask the patient's spouse to sign the consent form immediately
  3. Delay all care until the patient becomes fully orientated
  4. Follow the formal capacity assessment and best-interests process Correct answer.

Explanation

Capacity is decision-specific and should be formally assessed; when a patient lacks capacity for a particular decision, care must follow the applicable best-interests framework, involving family and the multidisciplinary team as appropriate. A spouse cannot simply consent on the patient's behalf.

Question 8Professional and ethical nursing practice

A competent adult refuses a prescribed blood transfusion. What should the nurse do?

  1. Document the refusal and stop all other care
  2. Respect the refusal and document the discussion and care offered Correct answer.
  3. Ask the family to persuade the patient to accept
  4. Administer it because it is prescribed and life-saving

Explanation

A competent adult has the right to refuse any treatment, including life-sustaining treatment, and the nurse must respect that decision. The discussion and continuing care should be documented, and other appropriate care should continue.

Question 9Professional and ethical nursing practice

A patient asks a nurse to attend their family party as a guest. What is the most appropriate response?

  1. Decline and explain the need for professional boundaries Correct answer.
  2. Accept because it will build trust with the patient
  3. Decline and ask another nurse to take over the patient's care
  4. Accept but avoid discussing work at the party

Explanation

Professional boundaries protect both the patient and the nurse; social involvement can create dual relationships and impair objective judgement. The nurse should decline politely and explain the professional nature of the relationship.

Question 10Professional and ethical nursing practice

A nurse wants to post a photo of a patient's wound on a private social media group to seek advice. What is the most appropriate action?

  1. Ask a colleague to post it on their personal account
  2. Post it if the patient's face is not visible
  3. Post it only in a closed group of nursing colleagues
  4. Do not post it; use approved clinical channels and consent Correct answer.

Explanation

Patient images are personal data and must not be shared on personal social media, even in closed groups or when the face is hidden, because the patient may still be identifiable. Advice should be sought through approved clinical channels, with consent where required.

Question 11Professional and ethical nursing practice

Which entry meets the standard for nursing documentation?

  1. Patient appears somewhat unsettled today; will continue to monitor
  2. Given medication as prescribed. RN A. Byrne
  3. 10:00 pain 7/10; analgesia given; reviewed 10:30. A. Byrne RN Correct answer.
  4. Patient very difficult and attention-seeking today

Explanation

Documentation should be factual, objective, contemporaneous, signed and include relevant assessment findings, interventions and evaluations. Subjective or judgemental language should be avoided.

Question 12Professional and ethical nursing practice

A nurse realises a patient has received the wrong dose of insulin. What should the nurse do first?

  1. Ask a colleague to observe the patient and not record the event
  2. Assess the patient and report the error immediately Correct answer.
  3. Wait to see whether the patient develops symptoms
  4. Document the error later at the end of the shift

Explanation

The immediate priority is patient safety: assess the patient, escalate for medical review and report the error promptly. Documentation, open disclosure and incident reporting follow as part of the response.

Question 13Professional and ethical nursing practice

A registered nurse delegates a simple dressing change to a healthcare assistant. Who remains accountable for the delegation decision?

  1. The ward manager on duty at the time
  2. The healthcare assistant who performs the task
  3. The patient who agreed to the task
  4. The registered nurse who delegated the task Correct answer.

Explanation

The registered nurse remains accountable for assessing the assistant's competence, providing supervision and evaluating the outcome of delegated care. The healthcare assistant is accountable for the actions they personally perform.

Question 14Professional and ethical nursing practice

A nurse is asked to perform a procedure they have not been trained for and that is outside their scope of practice. What is the most appropriate response?

  1. Perform it under supervision of a colleague who has done it before
  2. Ask a healthcare assistant to perform it instead
  3. Perform it because a doctor has requested it
  4. Decline and inform the employer so training or cover can be arranged Correct answer.

Explanation

Nurses must practise within their scope of practice and their individual competence. Declining and escalating protects patients and allows the employer to arrange training or alternative cover.

Question 15Professional and ethical nursing practice

A nurse repeatedly observes a colleague failing to follow infection control precautions. What is the most appropriate action?

  1. Post an anonymous warning on a staff social media page
  2. Report it through the appropriate internal governance channels Correct answer.
  3. Ignore it to avoid damaging team relationships
  4. Confront the colleague publicly in front of patients

Explanation

The nurse has a professional duty to protect patient safety and should raise concerns through line management or clinical governance, where whistleblower protections apply. Concerns should be reported factually and confidentially.

Question 16Professional and ethical nursing practice

A child presents with injuries inconsistent with the explanation given. What should the nurse do?

  1. Follow local child protection procedures and report the concern Correct answer.
  2. Record the injuries and continue routine care only
  3. Wait for the next scheduled appointment to review
  4. Ask the parents to explain the injuries again before taking action

Explanation

Nurses have a duty to safeguard children and must follow local child protection procedures when injuries are unexplained or inconsistent with the history. Reporting to the designated officer allows assessment without the nurse investigating.

Question 17Professional and ethical nursing practice

A patient who does not speak English appears unable to understand the planned procedure. What is the nurse's best action?

  1. Proceed and explain the procedure after it is done
  2. Use the patient's child to interpret the conversation
  3. Arrange a professional interpreter before continuing Correct answer.
  4. Ask another patient who speaks the language to help

Explanation

Advocacy and valid consent require effective communication, so a professional interpreter should be arranged before the procedure. Children and other patients should not be used as interpreters because of confidentiality, accuracy and power issues.

Question 18Professional and ethical nursing practice

Which action best protects a patient's dignity during personal care?

  1. Carrying out care without explaining what will happen
  2. Closing curtains and covering the patient where possible Correct answer.
  3. Leaving the curtain partly open for observation
  4. Discussing the patient's care with a colleague at the bedside

Explanation

Dignity includes privacy, respectful communication and involving the patient in decisions about their care. Closing curtains and covering the patient reduces exposure and preserves modesty.

Question 19Professional and ethical nursing practice

A patient offers a nurse an expensive gift after discharge. What is the most appropriate response?

  1. Accept it only if the patient insists several times
  2. Accept it and share it with the ward team
  3. Decline politely and follow the employer's gifts policy Correct answer.
  4. Accept it because refusing would embarrass the patient

Explanation

Accepting valuable gifts can create a conflict of interest or the perception of favouritism, so nurses should decline politely and follow their employer's gifts and hospitality policy. A card or small token may be acceptable under local policy.

Question 20Professional and ethical nursing practice

A nurse has a conscientious objection to assisting with a particular procedure. What is the correct professional approach?

  1. Perform the procedure but document the objection
  2. Try to persuade the patient to choose a different treatment option
  3. Inform the manager in advance so alternative cover can be arranged Correct answer.
  4. Refuse without explanation and leave the area

Explanation

A conscientious objection must be declared in advance so that care is not disrupted and alternative arrangements can be made. The nurse must not abandon the patient or impose their views on the patient.

Question 21Professional and ethical nursing practice

A patient with advanced illness has a valid do-not-attempt-resuscitation order. The patient collapses. What should the nurse do?

  1. Provide comfort care and follow the documented plan Correct answer.
  2. Wait for the family to decide what to do
  3. Start CPR because it is an emergency
  4. Call a cardiac arrest and begin chest compressions

Explanation

A valid DNAR order means that CPR should not be attempted; the nurse should provide comfort care and follow the documented plan. The order should be reviewed and respected, and the team informed.

Question 22Professional and ethical nursing practice

A patient's cultural practices conflict with the ward routine. What is the most appropriate nursing approach?

  1. Record the request but take no further action
  2. Discuss needs and negotiate flexible care where safe Correct answer.
  3. Ask the patient to follow the ward routine for consistency
  4. Refer the patient to another hospital with a different policy

Explanation

Culturally safe care involves respect for the patient's beliefs and practices, open discussion and negotiation, provided care remains safe and clinically appropriate. Rigid routines should not override reasonable cultural needs.

Question 23Professional and ethical nursing practice

Which statement about a student nurse's accountability is correct?

  1. The student may delegate to healthcare assistants
  2. The student is fully accountable for every aspect of care given
  3. The student has no responsibility for their own actions
  4. The student works under supervision and reports concerns Correct answer.

Explanation

Student nurses are accountable for their own actions within their developing competence and must work under supervision, reporting concerns promptly. The registered nurse remains accountable for care delegated to the student.

Question 24Professional and ethical nursing practice

What is required for a nurse to maintain registration with NMBI?

  1. A minimum of five years' experience
  2. Ongoing continuing professional development Correct answer.
  3. Attendance at one annual nursing conference each year
  4. Membership of a nursing union

Explanation

Maintaining registration requires ongoing demonstration of professional competence, including continuing professional development and adherence to the Code. Attendance at a single event or union membership does not meet this requirement.

Question 25Professional and ethical nursing practice

A nurse is asked to recruit patients for a study. Which action best protects participants?

  1. Offer extra care only to those who agree to take part
  2. Obtain voluntary informed consent after full disclosure Correct answer.
  3. Use a relative's signature when the patient is undecided
  4. Enrol patients who are too unwell to object

Explanation

Research ethics require voluntary informed consent after full disclosure, without coercion, and with ethics approval and the right to withdraw. Inducements or enrolling vulnerable patients without proper consent breach these requirements.

Question 26Professional and ethical nursing practice

The NMBI Code of Professional Conduct and Ethics is built on core principles. Which of the following is one of these principles?

  1. Priority of the employer's commercial interests
  2. Respect for the dignity of the person Correct answer.
  3. Maximising the throughput of the clinical area
  4. Deference to the views of the most senior clinician present

Explanation

The Code is founded on principles such as respect for the dignity of the person, professional responsibility and accountability, quality of practice, and trust and confidentiality. These principles guide everyday clinical decision-making rather than institutional or commercial priorities.

Question 27Professional and ethical nursing practice

Two nurses discuss a named patient's diagnosis and family circumstances in a crowded hospital lift. A visitor later repeats the information. Which statement best describes the nurses' conduct?

  1. A breach of confidentiality, as patient information should only be shared where it cannot be overheard. Correct answer.
  2. Acceptable, because no written record of the patient's details was made at any point.
  3. Acceptable, because both nurses were directly involved in the patient's care and needed to discuss the plan.
  4. Acceptable, provided the patient's full name was not used during the conversation.

Explanation

Confidentiality requires that patient information be shared only with those who need it, in a setting where it cannot be overheard. Discussing identifiable details in a public lift is a breach even though no written record is created.

Question 28Professional and ethical nursing practice

A clinical team must decide which of two equally urgent patients receives the only available intensive care bed. Which ethical principle is most directly concerned with making this decision fairly?

  1. Justice Correct answer.
  2. Autonomy
  3. Non-maleficence
  4. Beneficence

Explanation

Justice concerns fairness in the distribution of resources and requires that decisions between competing claims be made on relevant and equitable criteria. Beneficence and non-maleficence concern doing good and avoiding harm to an individual patient, while autonomy concerns self-determination.

Question 29Professional and ethical nursing practice

A patient asks to see the notes written about them during their admission. What is the nurse's most appropriate response?

  1. Explain that the clinical notes are the property of the hospital and cannot be viewed by patients under any circumstances.
  2. Provide the notes immediately and without any documentation or formal process, since the patient is entitled to them.
  3. Refuse the request for now because reading the notes may upset the patient and set back their recovery.
  4. Explain that patients have a right of access to their records and refer the request through the correct hospital process. Correct answer.

Explanation

Patients have a legal and ethical right of access to their own health records, subject to limited exceptions. The nurse should facilitate the request through the correct hospital process rather than refuse it or hand over documents informally.

Question 30Professional and ethical nursing practice

A 7-year-old child requires suturing. The parent accompanies the child and agrees to the procedure. What is the nurse's most appropriate approach to the child?

  1. Delay the procedure until the child reaches 16 years of age.
  2. Obtain the child's written signature on the consent form before the procedure begins.
  3. Proceed without speaking to the child at all, since the parent's signed consent is legally sufficient for a child of this age.
  4. Seek the child's assent by explaining the procedure in age-appropriate terms before proceeding. Correct answer.

Explanation

A parent or guardian can give legally valid consent for a young child, but the child should still receive an explanation suited to their understanding and their assent should be sought. This respects the child's developing autonomy and reduces distress.

Question 31Professional and ethical nursing practice

A patient's adult daughter telephones the ward and asks the nurse for details of her mother's test results. The patient has not agreed to any information being shared. What should the nurse do?

  1. Give the information to the daughter, since a close family member is entitled to know about the patient's test results.
  2. Ask the daughter to send a written request on the patient's behalf.
  3. Decline to discuss the results and offer to ask the patient what she wishes to share. Correct answer.
  4. Confirm only whether the results are normal or abnormal.

Explanation

Confidentiality is owed to the patient, not to relatives, and information may be shared only with the patient's consent or where there is a legal basis. The nurse should protect the patient's information and offer to check what the patient wants shared.

Question 32Professional and ethical nursing practice

At the start of a night shift a nurse notices that a colleague smells strongly of alcohol and is slurring words. What is the nurse's priority action?

  1. Ask another colleague to work alongside the nurse and share the workload between them.
  2. Ensure patients are not left in the colleague's care and report the concern immediately to the nurse in charge. Correct answer.
  3. Wait until the shift has ended and then discuss the matter privately with the colleague before deciding what to do.
  4. Say nothing for now but keep a close watch on the colleague for the rest of the night shift.

Explanation

Patient safety takes priority, and a nurse who is unfit for practice through alcohol must be removed from patient care and the concern reported immediately through the line management structure. This also initiates support for the colleague.

Question 33Professional and ethical nursing practice

An older patient with delirium repeatedly climbs out of bed at night and is at risk of falling. A colleague suggests tying the patient into bed. What is the nurse's most appropriate response?

  1. Agree to the suggestion, because preventing a fall in an older adult takes priority over the patient's freedom of movement.
  2. Ask the family to sign a consent form authorising the staff to use restraint at night.
  3. Explore less restrictive measures first, such as extra supervision and a low bed, and discuss with the team. Correct answer.
  4. Apply the restraint only at night, and record the decision in the nursing notes afterwards so that it is documented.

Explanation

Restraint is an intervention of last resort that must be justified, proportionate and used within a legal and prescribed framework after less restrictive options have been tried. The nurse must advocate for the least restrictive approach and involve the wider team.

Question 34Professional and ethical nursing practice

A nurse is alone in the treatment room when a colleague asks them to witness the disposal of a partly used ampoule of morphine. What is the most appropriate action?

  1. Ask a healthcare assistant who is nearby to witness the disposal instead of a registered nurse.
  2. Sign the record as witness so that the documentation is complete, and remind the colleague not to ask again.
  3. Dispose of the ampoule without recording it, since the leftover amount is small and clinically insignificant.
  4. Wait until a second registered nurse is present so the wastage can be witnessed and recorded. Correct answer.

Explanation

Controlled drugs require a strict two-person check for administration and disposal, with both registrants witnessing and signing the record. Signing as sole witness or involving an unqualified person undermines the audit trail that protects patients and staff.

Question 35Professional and ethical nursing practice

A patient with a fractured femur tells the nurse that their pain relief is not working and that they have told the medical team twice without any change. The patient appears distressed. What is the nurse's most appropriate action?

  1. Wait until the next scheduled medical ward round to raise the issue on the patient's behalf.
  2. Advise the patient to make a formal written complaint before any change to the prescription can be made.
  3. Reassess the pain, document findings and escalate the patient's concerns promptly to the prescriber. Correct answer.
  4. Tell the patient that the dose prescribed is already the maximum that can safely be given at this stage.

Explanation

Advocacy means acting with the patient to ensure their concerns are heard and acted upon. Reassessment, documentation and prompt escalation to the prescriber is the appropriate professional response to uncontrolled pain.

Question 36Professional and ethical nursing practice

A patient's family asks the nurse not to tell the patient that their cancer has spread; the patient later asks the nurse directly whether the results were bad. What is the nurse's most appropriate response?

  1. Explore what the patient already knows and wishes to know, then arrange for the medical team to discuss the results. Correct answer.
  2. Tell the patient that the results were normal, in order to respect the family's stated wishes and avoid distress.
  3. Tell the patient to ask their family about the results, since the family has already been fully informed.
  4. Say that nurses are not permitted to discuss results and end the conversation immediately.

Explanation

The nurse must not deceive the patient. Establishing what the patient knows and wants to know, then ensuring information is given by the appropriate clinician with support, respects both honesty and the family's concerns.

Question 37Professional and ethical nursing practice

A nurse is returning to clinical practice after five years working in a non-clinical role. What is the most appropriate action before caring for patients on the ward?

  1. Ask to be rostered only on day shifts for the first month, until confidence returns.
  2. Rely on colleagues to point out anything that has changed since the nurse last worked clinically.
  3. Begin work immediately on the ward, since registration has been maintained without interruption throughout the five years away from clinical practice.
  4. Complete a recognised return-to-practice programme and discuss a supported orientation with the employer. Correct answer.

Explanation

Nurses must practise only within their current competence and take steps to update knowledge and skills after a period away from practice. A return-to-practice programme and supported orientation demonstrate accountability for safe care.

Question 38Professional and ethical nursing practice

A patient with a treatable sexually transmitted infection refuses to tell their partner and refuses to allow the nurse to do so, saying the relationship will end. What is the nurse's most appropriate course of action?

  1. Tell the partner immediately, because the duty to protect a third party at risk always overrides the duty of confidentiality owed to the patient.
  2. Record the partner's contact details and ask a colleague to make an anonymous telephone call to the partner about the infection risk without revealing the source.
  3. Encourage and support disclosure, and if the patient still refuses, seek senior advice and follow national guidance on disclosure in the public interest. Correct answer.
  4. Take no further action of any kind, because the patient's right to confidentiality is absolute and cannot be breached in any circumstances whatsoever.

Explanation

Confidentiality is a strong but not absolute duty; disclosure to a third party at risk may be justified only where it is necessary and proportionate. This follows efforts to obtain the patient's cooperation and is done in line with national guidance and senior advice.

Question 39Professional and ethical nursing practice

The nurse in charge of a ward is told by the duty manager that no replacement staff are available and that the ward must 'manage'. The ward is below the agreed safe staffing level for the acuity of the patients. What is the most appropriate professional response?

  1. Refuse to accept responsibility for the shift and leave the ward, since the nurse cannot be held accountable for staffing decisions made by managers.
  2. Ask the healthcare assistants to take on the more complex patients so that the registered nurses can cover the remaining patients between them.
  3. Assess and document the risk, report it through the risk-escalation process, and continue to escalate while taking all reasonable steps to protect patients. Correct answer.
  4. Accept the decision quietly, because the safe staffing of the ward is a responsibility of senior management rather than of the nurse in charge.

Explanation

The nurse in charge is accountable for the safety of patients on the shift and must manage and escalate risk through formal risk and incident processes. Documenting and escalating protects patients and creates an organisational record of the concern.

Question 40Professional and ethical nursing practice

A patient tells a nurse that they have developed strong romantic feelings for the nurse and asks to meet after discharge. What is the nurse's most appropriate response?

  1. Ignore the comment completely so as not to embarrass the patient, and continue care as before without comment.
  2. Explain that nurses are not permitted to speak with patients about personal matters of any kind during an admission.
  3. Acknowledge the patient's feelings, restate the professional limits of the relationship and inform the nurse in charge. Correct answer.
  4. Agree to meet the patient socially after discharge, since the professional relationship will have ended by that time.

Explanation

Nurses must maintain professional boundaries and use the professional relationship only to meet the patient's needs. Acknowledging feelings kindly, clarifying limits and informing the nurse in charge protects both the patient and the nurse.

Question 41Clinical nursing knowledge and applied physiology

What is the normal resting heart rate range for a healthy adult?

  1. 60 to 100 beats/min Correct answer.
  2. 40 to 60 beats/min
  3. 120 to 140 beats/min
  4. 100 to 120 beats/min

Explanation

A normal adult resting heart rate is typically 60 to 100 beats per minute. Rates below 60 are bradycardia, while rates above 100 are tachycardia.

Question 42Clinical nursing knowledge and applied physiology

What is the normal resting respiratory rate range for a healthy adult?

  1. 12 to 20 breaths/min Correct answer.
  2. 10 to 14 breaths/min
  3. 8 to 12 breaths/min
  4. 20 to 28 breaths/min

Explanation

A normal adult resting respiratory rate is typically 12 to 20 breaths per minute. Rates outside this range may indicate respiratory or metabolic disturbance.

Question 43Clinical nursing knowledge and applied physiology

Which electrolyte is the principal cation in extracellular fluid?

  1. Magnesium
  2. Potassium
  3. Sodium Correct answer.
  4. Calcium

Explanation

Sodium is the main positively charged ion in extracellular fluid and largely determines plasma osmolality. Potassium is the principal intracellular cation.

Question 44Clinical nursing knowledge and applied physiology

Which oral temperature is within the normal adult range?

  1. 34.5 C
  2. 35.5 C
  3. 38.5 C
  4. 37.0 C Correct answer.

Explanation

A typical normal adult oral temperature is about 36.5 to 37.5 C. A value of 37.0 C falls within this range.

Question 45Clinical nursing knowledge and applied physiology

Deficiency of which vitamin causes scurvy?

  1. Vitamin D
  2. Vitamin C Correct answer.
  3. Vitamin A
  4. Vitamin K

Explanation

Vitamin C is required for collagen synthesis, and deficiency leads to scurvy with bleeding gums and poor wound healing. The other vitamins listed have different deficiency syndromes.

Question 46Clinical nursing knowledge and applied physiology

Before giving a prescribed oral medicine, what is the most appropriate way to confirm patient identity?

  1. Confirm identity with the patient's family member
  2. Check the name on the medicine chart against the bed number
  3. Use two identifiers, such as name and date of birth Correct answer.
  4. Ask the patient to state their date of birth only

Explanation

Safe medication administration requires confirmation of identity using two independent patient identifiers. Bed numbers and family confirmation are not reliable substitutes.

Question 47Clinical nursing knowledge and applied physiology

Which medication route generally produces the fastest systemic effect?

  1. Intravenous Correct answer.
  2. Subcutaneous
  3. Oral
  4. Transdermal

Explanation

Intravenous administration places medicine directly into the bloodstream, so systemic onset is generally fastest. Oral, subcutaneous and transdermal routes involve absorption steps that delay onset.

Question 48Clinical nursing knowledge and applied physiology

For a stable adult, what minimum hourly urine output generally indicates adequate renal perfusion?

  1. 0.5 mL/kg/hr Correct answer.
  2. 0.3 mL/kg/hr
  3. 0.2 mL/kg/hr
  4. 0.1 mL/kg/hr

Explanation

An adult urine output of at least 0.5 mL/kg/hr is generally used as the minimum indicator of adequate renal perfusion. Lower outputs may suggest hypovolaemia or renal impairment.

Question 49Clinical nursing knowledge and applied physiology

Which intravenous fluid is isotonic with plasma?

  1. 0.9% sodium chloride Correct answer.
  2. 0.225% sodium chloride
  3. 0.45% sodium chloride
  4. 3% sodium chloride

Explanation

0.9% sodium chloride is an isotonic crystalloid with an osmolality similar to plasma. The other concentrations listed are hypotonic or hypertonic.

Question 50Clinical nursing knowledge and applied physiology

Which clinical finding is most characteristic of hypokalaemia?

  1. Muscle weakness and arrhythmias Correct answer.
  2. Polyuria and hyperpigmentation
  3. Tetany and hyperreflexia
  4. Hypertension and bradycardia

Explanation

Low serum potassium reduces neuromuscular excitability and can cause muscle weakness and cardiac arrhythmias. Tetany is more typical of hypocalcaemia, and polyuria with hyperpigmentation suggests adrenal insufficiency.