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OSSSC Staff Nurse practice questions

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Question 1Nursing

A patient is receiving intravenous fluids through a peripheral cannula. Which finding at the insertion site should the nurse report immediately as a sign of infiltration?

  1. Mild redness limited to the cannula hub without swelling
  2. A small bruise at the puncture site with brisk flow
  3. Clear fluid dripping from the tubing connection
  4. Cool, pale, swollen skin around the cannula with slowed flow Correct answer.

Explanation

Infiltration occurs when fluid leaks into surrounding tissue, producing coolness, pallor, swelling and reduced flow because the fluid is no longer entering the vein. Bruising alone or hub redness does not indicate fluid in tissue. A leaking connection is a tubing problem rather than infiltration.

Question 2Nursing

Which route of drug administration is most appropriate for a nurse to use when a patient is prescribed a sublingual tablet?

  1. Swallowed whole with a glass of water
  2. Placed under the tongue and allowed to dissolve Correct answer.
  3. Placed between the cheek and gum
  4. Crushed and mixed with fruit juice

Explanation

Sublingual tablets are placed under the tongue, where the rich blood supply allows rapid absorption directly into the systemic circulation and avoids first-pass hepatic metabolism. Swallowing or crushing defeats this purpose. The buccal route is between cheek and gum, which is a different route.

Question 3Nursing

A nurse is calculating a pediatric dose. The child weighs 18 kg and the prescribed dose is 5 mg/kg per day given in two divided doses. How many milligrams should each dose contain?

  1. 22.5 mg
  2. 18 mg
  3. 45 mg Correct answer.
  4. 90 mg

Explanation

The total daily dose is 18 kg multiplied by 5 mg/kg, which equals 90 mg per day. Dividing 90 mg into two doses gives 45 mg per dose. Failing to divide by two yields the daily total rather than the individual dose.

Question 4Nursing

Which instruction should the nurse give a patient starting a course of oral rifampicin for tuberculosis?

  1. Avoid all fluids for two hours after each dose
  2. Stop the drug as soon as fever subsides
  3. Expect orange-red discolouration of urine, sweat and tears Correct answer.
  4. Take the drug only on an empty stomach at bedtime

Explanation

Rifampicin harmlessly stains body fluids orange-red, and patients must be warned so they are not alarmed and do not abandon treatment. It is taken regularly for the full course because stopping early promotes resistance. Fluid restriction is not part of the regimen.

Question 5Nursing

A patient with diarrhoea has sunken eyes, dry mucous membranes and a capillary refill time of four seconds. Which classification of dehydration does this represent?

  1. Severe dehydration requiring intravenous fluids Correct answer.
  2. Some dehydration managed with oral rehydration salts only
  3. Overhydration requiring fluid restriction
  4. No dehydration

Explanation

Sunken eyes, dry mucous membranes and delayed capillary refill are signs of severe dehydration, which requires urgent intravenous rehydration. Some dehydration shows fewer and milder signs and is managed with oral rehydration salts. Overhydration would show different features such as oedema and raised jugular venous pressure.

Question 6Nursing

Which position is safest for a patient who has just vomited while lying in bed and is drowsy?

  1. Supine with the head flat
  2. Left lateral position with the head turned to the side Correct answer.
  3. Prone with the face down on the pillow
  4. High Fowler position with legs extended

Explanation

A lateral position with the head turned allows vomitus to drain from the mouth and protects the airway in a drowsy patient at risk of aspiration. Supine positioning allows vomit to pool in the pharynx. Prone positioning with the face down obstructs the mouth and airway.

Question 7Nursing

A nurse is preparing to give an intramuscular injection to an adult. Which site carries the greatest risk of injury to the sciatic nerve?

  1. Vastus lateralis site
  2. Dorsogluteal site Correct answer.
  3. Deltoid site
  4. Ventrogluteal site

Explanation

The dorsogluteal site lies close to the sciatic nerve and major vessels, so inaccurate landmarking can cause nerve injury, which is why it is discouraged. The ventrogluteal site is preferred because it is free of major nerves and vessels. Deltoid and vastus lateralis sites are distant from the sciatic nerve.

Question 8Nursing

A patient on furosemide reports muscle weakness and cramps. Which electrolyte imbalance should the nurse suspect?

  1. Hyperkalaemia
  2. Hypercalcaemia
  3. Hypernatraemia
  4. Hypokalaemia Correct answer.

Explanation

Furosemide is a loop diuretic that increases potassium loss in urine, and hypokalaemia produces muscle weakness, cramps and cardiac dysrhythmias. Hyperkalaemia is not typical with loop diuretics. Sodium and calcium excess do not classically produce this pattern with furosemide.

Question 9Nursing

Which observation best indicates that a newborn is receiving effective breastfeeding in the first days of life?

  1. Continuous rapid sucking without pauses
  2. Falling asleep immediately at the start of each feed
  3. Maternal nipple pain throughout the feed
  4. Audible swallowing with slow, deep sucks during feeds Correct answer.

Explanation

Effective feeding shows slow deep sucks with audible swallowing and pauses, indicating milk transfer. Continuous rapid sucking without swallowing suggests poor attachment. Sleeping at the start of feeds and persistent nipple pain suggest ineffective latch.

Question 10Nursing

A woman at 32 weeks of gestation reports painless bright red vaginal bleeding. Which condition should the nurse suspect first?

  1. Placenta praevia Correct answer.
  2. Abruptio placentae
  3. Ectopic pregnancy
  4. Threatened miscarriage

Explanation

Painless bright red bleeding in late pregnancy is characteristic of placenta praevia, where the placenta covers or lies near the cervical os. Abruptio placentae typically presents with painful bleeding and a tender uterus. Ectopic pregnancy and miscarriage occur earlier in pregnancy.

Question 11Nursing

Which finding on a cardiotocograph trace should prompt immediate escalation during labour?

  1. Baseline rate of 140 beats per minute with moderate variability
  2. Accelerations of 15 beats lasting 15 seconds
  3. Early decelerations coinciding with contractions
  4. Persistent late decelerations with reduced baseline variability Correct answer.

Explanation

Persistent late decelerations with reduced variability indicate fetal hypoxia and placental insufficiency and require urgent action such as repositioning and medical review. A baseline of 140 with moderate variability is normal. Accelerations are reassuring, and early decelerations are benign head compression.

Question 12Nursing

A patient has a stage 2 pressure ulcer over the sacrum. Which description matches this stage?

  1. Full-thickness loss with visible subcutaneous fat but no bone
  2. Full-thickness loss extending to bone or tendon
  3. Intact skin with non-blanchable redness
  4. Partial-thickness loss of skin with a shallow open ulcer or blister Correct answer.

Explanation

Stage 2 pressure injury involves partial-thickness skin loss presenting as a shallow open ulcer or an intact or ruptured blister. Intact skin with non-blanchable redness is stage 1. Full-thickness loss reaching bone or tendon is stage 4, and full-thickness loss with visible fat is stage 3.

Question 13Nursing

Which action should the nurse take first when a patient with a tracheostomy suddenly develops severe respiratory distress and the tube appears blocked?

  1. Administer a prescribed sedative to reduce anxiety
  2. Suction the tracheostomy and assess airway patency Correct answer.
  3. Increase the oxygen flow through the humidifier
  4. Document the event and inform the family

Explanation

Airway takes priority, so the nurse should suction and assess patency, removing secretions or a mucus plug that may be obstructing the tube. Increasing oxygen flow will not help if the tube is blocked. Documentation and sedation are secondary and delay lifesaving intervention.

Question 14Nursing

A patient with chronic obstructive pulmonary disease is prescribed oxygen. Which target is generally appropriate?

  1. Controlled oxygen to keep saturation around 88 to 92 per cent Correct answer.
  2. High-flow oxygen to keep saturation above 98 per cent
  3. Oxygen only when the patient becomes unconscious
  4. No oxygen at all regardless of saturation

Explanation

In COPD with chronic carbon dioxide retention, controlled oxygen targeting roughly 88 to 92 per cent saturation avoids worsening hypercapnia while correcting hypoxaemia. High-flow oxygen risks carbon dioxide narcosis. Withholding oxygen until unconsciousness is dangerous and unnecessary.

Question 15Nursing

Which measure is most important for preventing catheter-associated urinary tract infection?

  1. Adding antiseptic to the drainage bag
  2. Routine irrigation of the catheter every shift
  3. Changing the drainage bag daily
  4. Removing the catheter as soon as it is no longer indicated Correct answer.

Explanation

The single most effective preventive measure is to avoid unnecessary catheterisation and remove the catheter promptly when no longer needed. Routine irrigation, frequent bag changes and antiseptics in the bag do not prevent infection and may introduce organisms.

Question 16Nursing

A nurse receives a verbal order for a high-alert medication. Which action is most appropriate?

  1. Wait until the next shift to clarify the order
  2. Ask another nurse to write the order in the chart
  3. Accept the order and administer the drug immediately
  4. Read the order back to the prescriber and confirm it in writing Correct answer.

Explanation

Verbal orders for high-alert drugs require read-back verification to confirm accuracy and must be documented and countersigned by the prescriber according to policy. Administering immediately without confirmation risks error. Another nurse cannot legitimately authorise a prescriber's order.

Question 17Nursing

Which client is at highest risk of developing a deep vein thrombosis after surgery?

  1. A 65-year-old who had major hip surgery and is immobile Correct answer.
  2. A 40-year-old who had a dressing change and is ambulatory
  3. A 30-year-old who had a tooth extraction and is active
  4. A 25-year-old who had a minor skin excision and walks freely

Explanation

Major orthopaedic surgery, older age and immobility are classic Virchow triad risks for deep vein thrombosis because venous stasis and endothelial injury combine. The other clients have minor procedures and remain mobile, which greatly lowers their risk.

Question 18Nursing

Which sign suggests that a patient with a head injury is developing raised intracranial pressure?

  1. Bradycardia with a rising blood pressure and irregular respiration
  2. Sudden improvement in orientation
  3. Warm dry skin with a normal pulse
  4. Falling level of consciousness with unequal pupils Correct answer.

Explanation

A declining level of consciousness and unequal pupils are early warning signs of rising intracranial pressure and impending herniation. Cushing triad, combining bradycardia, hypertension and irregular respiration, is a late sign. Improvement in orientation and normal vital signs are not indicators of raised pressure.

Question 19Nursing

A patient is prescribed 500 mL of normal saline over 4 hours using a giving set with a drop factor of 20 drops per mL. What is the correct drip rate?

  1. 42 drops per minute Correct answer.
  2. 125 drops per minute
  3. 21 drops per minute
  4. 63 drops per minute

Explanation

The formula is volume in mL multiplied by drop factor, divided by time in minutes. That gives 500 times 20 divided by 240, which equals about 42 drops per minute. Halving the volume or using the wrong time denominator gives the other figures.

Question 20Nursing

Which precaution is required when caring for a patient with pulmonary tuberculosis who is coughing?

  1. Standard precautions only with gloves
  2. Contact precautions with gown and gloves
  3. Airborne precautions with a fit-tested N95 respirator Correct answer.
  4. Droplet precautions with a surgical mask at one metre

Explanation

Pulmonary tuberculosis spreads by airborne droplet nuclei, so an airborne infection isolation room and a fit-tested N95 respirator are required. Standard precautions alone are insufficient. Droplet precautions apply to organisms spread by large droplets, and contact precautions target skin and surface contamination.

Question 21Nursing

A patient with type 1 diabetes has a blood glucose of 2.8 mmol/L, is sweating and confused but can swallow. What is the nurse's first action?

  1. Administer the usual dose of long-acting insulin
  2. Withhold all carbohydrate until the next meal
  3. Give 15 to 20 g of fast-acting oral carbohydrate and recheck glucose in 15 minutes Correct answer.
  4. Start an intravenous insulin infusion

Explanation

Hypoglycaemia with preserved swallowing is treated with fast-acting oral carbohydrate such as glucose tablets or juice, followed by rechecking glucose after about 15 minutes. Insulin would deepen the hypoglycaemia. Withholding carbohydrate and starting insulin are both dangerous in this setting.

Question 22Nursing

Which finding indicates that a patient's nasogastric feeding should be withheld pending review?

  1. A gastric residual volume well above the unit threshold with abdominal distension Correct answer.
  2. Mild thirst reported by the patient
  3. A residual volume within the normal range
  4. A securely taped tube at the correct mark

Explanation

A high gastric residual volume with abdominal distension suggests delayed gastric emptying and raises the risk of aspiration, so feeding should be paused and reviewed. Residuals within the accepted range, thirst and a correctly positioned tube do not require withholding feeds.

Question 23Nursing

Which statement about hand hygiene is correct according to standard practice?

  1. Alcohol-based hand rub is preferred for visibly clean hands before patient contact Correct answer.
  2. Gloves remove the need for hand hygiene after removal
  3. Hands must be washed with soap and water after every single patient contact regardless of soiling
  4. Alcohol rub is effective against bacterial spores such as Clostridium difficile

Explanation

Alcohol-based hand rub is the preferred method when hands are not visibly soiled because it is faster and more effective against most organisms. Soap and water are required when hands are visibly dirty or after caring for patients with spore-forming organisms. Gloves never replace hand hygiene.

Question 24Nursing

A patient has an arterial blood gas showing pH 7.28, PaCO2 6.7 kPa and bicarbonate 24 mmol/L. How should the nurse interpret this result?

  1. Metabolic acidosis
  2. Metabolic alkalosis
  3. Respiratory acidosis Correct answer.
  4. Respiratory alkalosis

Explanation

A low pH indicates acidosis, and the raised carbon dioxide with a normal bicarbonate points to a respiratory cause, meaning hypoventilation. Metabolic acidosis would show a low bicarbonate. Alkalosis would show a pH above the normal range.

Question 25Nursing

During the second stage of labour, which action best supports the mother while protecting the perineum?

  1. Telling the mother to push only while lying flat on her back
  2. Instructing sustained breath-holding pushing for as long as possible
  3. Applying fundal pressure during each contraction
  4. Encouraging controlled pushing with the mother's preferred upright position Correct answer.

Explanation

Controlled pushing in an upright position uses gravity, reduces prolonged breath-holding and lowers perineal trauma. Sustained breath-holding pushing reduces maternal oxygenation. Fundal pressure is unsafe and can cause uterine rupture, and supine pushing is not the optimal position.

Question 26Nursing

A patient is receiving a blood transfusion. Which early finding should make the nurse stop the transfusion immediately?

  1. Complaint of a metallic taste after eating
  2. Mild itching at the cannula site without rash
  3. Rise in temperature of 1 degree Celsius with chills and flank pain Correct answer.
  4. Gradual fall in haemoglobin over 24 hours

Explanation

Fever with chills, flank or back pain and a feeling of impending doom suggests an acute haemolytic transfusion reaction, which requires stopping the transfusion at once, maintaining venous access with saline and informing the blood bank. Mild itching alone is usually a local reaction and does not mimic this picture.

Question 27Nursing

Which instruction should the nurse give a patient who is starting treatment with rifampicin for tuberculosis?

  1. Stop the drug as soon as fever subsides
  2. Avoid all dairy products during therapy
  3. Expect orange discolouration of urine, sweat and tears Correct answer.
  4. Take the drug only on alternate days

Explanation

Rifampicin harmlessly colours body fluids orange-red, and patients must be warned so they are not alarmed and so soft contact lenses are avoided. The drug is taken daily and the full course completed; dairy does not need to be excluded.

Question 28Nursing

A patient with severe vomiting has a serum potassium of 3.0 mmol/L. Which nursing action is most important before administering intravenous potassium chloride?

  1. Administer the undiluted concentrate through a peripheral line
  2. Give the dose as a rapid bolus to correct the deficit quickly
  3. Withhold all potassium until the serum level is rechecked next week
  4. Confirm the drug is diluted and will be infused via a volumetric pump Correct answer.

Explanation

Undiluted or rapidly infused potassium can cause fatal cardiac arrhythmia, so it must be diluted and given by controlled infusion, usually no faster than 10 mmol per hour peripherally. A bolus or concentrate is dangerous, and correction should not be delayed for a week.

Question 29Nursing

Which assessment finding is most characteristic of hypoglycaemia in a patient with diabetes?

  1. Tremor, sweating and confusion Correct answer.
  2. Deep sighing respiration and fruity breath
  3. Polyuria with excessive thirst
  4. Gradual weight loss over months

Explanation

Hypoglycaemia produces autonomic symptoms such as tremor, sweating and palpitations together with neuroglycopenic features such as confusion. Fruity breath with deep respiration indicates ketoacidosis, while polyuria and thirst reflect hyperglycaemia.

Question 30Nursing

A postoperative patient suddenly becomes breathless and tachycardic and complains of pleuritic chest pain. Which complication should the nurse suspect first?

  1. Wound dehiscence
  2. Paralytic ileus
  3. Atelectasis from shallow breathing
  4. Pulmonary embolism Correct answer.

Explanation

Sudden dyspnoea, tachycardia and pleuritic pain in an immobile postoperative patient strongly suggest pulmonary embolism, requiring urgent medical review and oxygen. Atelectasis tends to develop gradually with low-grade fever, and the other options do not cause acute breathlessness.

Question 31Nursing

Which parameter should the nurse monitor most closely during the first hour of a blood transfusion?

  1. Pupil size and reaction
  2. Urine specific gravity every 15 minutes
  3. Deep tendon reflexes
  4. Vital signs, especially temperature and blood pressure Correct answer.

Explanation

Most acute transfusion reactions occur within the first 15 minutes, so baseline observations are recorded and vital signs are checked shortly after starting and at regular intervals. Urine specific gravity, pupils and reflexes are not relevant monitoring for transfusion.

Question 32Nursing

A woman in the first stage of labour is 4 cm dilated and her membranes have just ruptured. Which action should the nurse take immediately?

  1. Check the fetal heart rate and note the colour of the liquor Correct answer.
  2. Perform a vaginal examination to stretch the cervix
  3. Encourage her to walk to the toilet alone
  4. Ask her to push with the next contraction

Explanation

After membrane rupture the priority is to exclude cord prolapse and fetal compromise by auscultating the fetal heart and inspecting the liquor for meconium. Sending her alone to the toilet risks an unattended cord prolapse, and pushing is inappropriate at 4 cm.

Question 33Nursing

A newborn at 6 hours of age has a respiratory rate of 80 per minute with grunting and nasal flaring. Which action is most appropriate?

  1. Wrap the baby tightly and delay review until the next shift
  2. Apply a tight abdominal binder
  3. Provide warmth, keep the airway clear and escalate to the paediatric team Correct answer.
  4. Give oral feeds to strengthen the baby

Explanation

Tachypnoea above 60 with grunting and flaring indicates respiratory distress, so the nurse should maintain warmth and a clear airway, avoid oral feeding and obtain urgent medical review. Delaying review or binding the abdomen would worsen the condition.

Question 34Nursing

Which action best prevents ventilator-associated pneumonia in an intubated patient?

  1. Routine suctioning every 15 minutes regardless of need
  2. Keeping the head of the bed elevated to 30 to 45 degrees Correct answer.
  3. Keeping the patient flat and supine
  4. Changing the endotracheal tube daily

Explanation

Semi-recumbent positioning reduces aspiration of oropharyngeal secretions and is a core element of ventilator-associated pneumonia bundles. Suctioning should be done when indicated, tubes are not changed daily, and supine positioning increases aspiration risk.

Question 35Nursing

A patient is admitted with burns covering the entire right arm and the anterior trunk. Using the rule of nines, what percentage of total body surface area is affected?

  1. 27 percent Correct answer.
  2. 45 percent
  3. 18 percent
  4. 36 percent

Explanation

The whole right arm accounts for 9 percent and the anterior trunk for 18 percent, giving 27 percent. Remembering that each arm is 9 and each side of the trunk is 18 allows quick estimation for fluid resuscitation planning.

Question 36Nursing

A patient with a new colostomy asks how to care for the stoma at home. Which instruction is correct?

  1. Leave the pouch off for several hours each day
  2. Wash the stoma gently with plain warm water and pat dry Correct answer.
  3. Scrub the stoma with antiseptic solution daily
  4. Apply a tight belt directly over the stoma

Explanation

A healthy stoma is cleaned with plain warm water, dried gently and covered with a correctly sized pouch; soap and antiseptics can irritate the mucosa. Tight belts and prolonged pouch-free periods risk skin damage and leakage.

Question 37Nursing

Which finding should alert the nurse to early hypovolaemic shock in an adult after a road traffic accident?

  1. Bradycardia with hypertension
  2. Warm dry skin with bounding pulses
  3. Increased urine output with clear urine
  4. Restlessness, rising pulse and narrowing pulse pressure Correct answer.

Explanation

Early shock presents with anxiety or restlessness, tachycardia, a falling systolic pressure and narrowing pulse pressure as compensation fails. Bradycardia with hypertension and warm bounding pulses are not features of hypovolaemia.

Question 38Nursing

A patient with a chest drain after lobectomy has continuous bubbling in the water-seal chamber. What should the nurse do?

  1. Check all connections for an air leak and inform the surgeon Correct answer.
  2. Add more water to the suction-control chamber
  3. Milk the tubing vigorously
  4. Clamp the tube immediately and leave it clamped

Explanation

Continuous bubbling in the water-seal chamber usually indicates an air leak in the system or from the lung, so connections should be checked and the team informed. Clamping a bubbling tube risks tension pneumothorax, and milking is not routine.

Question 39Nursing

Which dietary advice is appropriate for a patient with chronic kidney disease who is not yet on dialysis?

  1. Limit sodium and potassium and moderate protein intake Correct answer.
  2. Take high-dose vitamin C supplements routinely
  3. Increase potassium-rich fruits such as bananas daily
  4. Drink at least five litres of water daily

Explanation

Before dialysis, restricting sodium, potassium and phosphorus and moderating protein helps control uraemia and fluid overload. High-potassium foods and forced large fluid intake risk hyperkalaemia and overload.

Question 40Nursing

A patient on regular opioid analgesia for cancer pain develops constipation. Which measure should the nurse recommend first?

  1. Increase dietary fibre and fluids and use a prescribed laxative regularly Correct answer.
  2. Reduce all fluid intake to harden stools
  3. Stop the opioid completely without medical advice
  4. Use an enema every day as routine

Explanation

Opioid-induced constipation is expected and managed with adequate fibre, fluids, mobility and a prophylactic laxative prescribed by the clinician. Abruptly stopping analgesia causes pain crisis, and daily enemas are not a first-line routine.

Question 41Nursing

Which action should the nurse take when a patient refuses a prescribed oral medication?

  1. Respect the refusal, document it and inform the prescriber Correct answer.
  2. Hide the tablet in food without telling the patient
  3. Record the dose as given to avoid a gap in the chart
  4. Force the medication to ensure compliance

Explanation

A competent patient has the right to refuse treatment, and the nurse must document the refusal and notify the prescriber. Concealing medication, forcing treatment or falsifying records all violate consent and professional standards.

Question 42Nursing

A patient has been prescribed oxygen at 2 litres per minute by nasal cannula. Which nursing action is essential before starting therapy?

  1. Light a cigarette to test the flow
  2. Check the prescription, set the flow rate and confirm the humidifier and tubing are connected Correct answer.
  3. Apply petroleum jelly around the nostrils
  4. Set the flow as high as possible to be safe

Explanation

Oxygen is a drug, so the prescription, flow rate and equipment must be verified and documented. High unmonitored flow can harm patients with carbon dioxide retention, and petroleum jelly plus smoking are fire hazards near oxygen.

Question 43Nursing

Which patient is most at risk of falls on a medical ward?

  1. A 25-year-old with a sprained ankle who walks with crutches
  2. An 82-year-old taking a sedative and a diuretic Correct answer.
  3. A 45-year-old with well-controlled asthma
  4. A 30-year-old admitted for elective hernia repair

Explanation

Advanced age combined with sedatives and diuretics increases the risk of falls through impaired balance, drowsiness and nocturia. The other patients are younger, mobile and not on sedating or diuretic medication.

Question 44Nursing

A patient with a head injury has a Glasgow Coma Scale score that has fallen from 14 to 11 over two hours. What is the nurse's priority action?

  1. Document the score and continue routine observations
  2. Escalate immediately to the medical team and prepare for urgent imaging Correct answer.
  3. Recheck the score in four hours
  4. Give a strong sedative to settle the patient

Explanation

A falling Glasgow Coma Scale score signals neurological deterioration and possible rising intracranial pressure, so urgent medical review and imaging are needed. Delaying reassessment or sedating the patient would mask further deterioration.

Question 45Nursing

Which statement about standard precautions is correct?

  1. Gloves replace the need for hand hygiene
  2. Masks are required for every patient contact
  3. Gloves are worn for contact with blood and body fluids and hands are cleaned after glove removal Correct answer.
  4. Gowns must be worn for all bed-making

Explanation

Gloves protect only the wearer and must be removed and followed by hand hygiene, because gloves do not eliminate contamination. Masks and gowns are used when splash or contact risk exists, not for every contact or routine bed-making.

Question 46Nursing

A patient is prescribed 1 gram of paracetamol. The stock available is 500 mg tablets. How many tablets should the nurse administer?

  1. 1 tablet
  2. 4 tablets
  3. 2 tablets Correct answer.
  4. 0.5 tablet

Explanation

One gram equals 1000 mg, so two 500 mg tablets are needed. Setting up the calculation as dose required divided by stock strength gives 1000 divided by 500, which equals 2.

Question 47Nursing

A patient with severe pre-eclampsia is receiving magnesium sulphate. Which finding suggests magnesium toxicity?

  1. Bradycardia with warm dry skin
  2. Loss of deep tendon reflexes and respiratory depression Correct answer.
  3. Hypertension with headache
  4. Increased urine output and brisk reflexes

Explanation

Magnesium toxicity progresses from loss of deep tendon reflexes to respiratory depression and cardiac arrest, so reflexes, respiration and urine output are monitored. Brisk reflexes and increased urine output suggest the drug is not accumulating.

Question 48Nursing

Which position is recommended for a patient with acute severe dyspnoea from pulmonary oedema?

  1. Flat supine with legs raised
  2. Trendelenburg position
  3. Prone with the head turned
  4. Sitting upright with legs dependent Correct answer.

Explanation

Sitting upright reduces venous return and improves lung expansion, easing the work of breathing in pulmonary oedema. Supine, prone and head-down positions worsen breathlessness by increasing venous return and pressure on the diaphragm.

Question 49Nursing

A patient is scheduled for surgery and reports an allergy to penicillin. Which action is most important before the preoperative antibiotic is given?

  1. Omit the allergy from the theatre handover
  2. Confirm the allergy with the patient and check the prescribed antibiotic against it Correct answer.
  3. Document the allergy only after surgery
  4. Give the antibiotic as charted because the surgeon prescribed it

Explanation

Allergy status must be verified with the patient and cross-checked against the prescribed drug to prevent anaphylaxis. Administering blindly, omitting the allergy in handover or delaying documentation all risk serious harm.

Question 50Nursing

A patient with a nasogastric tube is due for a feed. Which check confirms correct tube placement before feeding?

  1. Check that the tube is taped securely
  2. Ask the patient whether the tube feels right
  3. Inject air and listen for a whoosh sound
  4. Measure the pH of aspirate and confirm it is acidic Correct answer.

Explanation

Aspirate pH of 5.5 or below supports gastric placement, ideally confirmed by radiography for new tubes. The auscultatory whoosh method and patient reassurance are unreliable, and secure taping does not confirm position.