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OET Nursing practice questions

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Question 1Listening

During a handover, a nurse says: "Mr Okafor's observations are stable, but he's been refusing his analgesia since this morning." What is the main concern the nurse is communicating?

  1. The patient has been discharged earlier than planned
  2. The patient needs a stronger analgesia prescription immediately
  3. The patient's vital signs are deteriorating rapidly
  4. The patient is declining pain relief despite being stable Correct answer.

Explanation

The speaker contrasts stable observations with the patient's refusal of analgesia, so the key message is that pain management is being declined even though the patient is otherwise stable. Listening for contrast markers such as "but" helps identify the point the speaker is emphasising.

Question 2Listening

A patient says: "I've had this cough for about three weeks now, and it's getting worse at night." Which detail would a nurse document as the duration of the symptom?

  1. The cough disturbs the patient's sleep
  2. The cough has lasted roughly three weeks Correct answer.
  3. The cough began after a recent cold
  4. The cough is worse at night

Explanation

Duration refers to how long a symptom has been present, and the patient states "about three weeks", so that is the documented duration. The other details describe timing or character of the symptom rather than its length.

Question 3Listening

In a discharge planning meeting, the physiotherapist says: "She can manage the stairs with a rail, but I'd want someone with her for the first fortnight." What does the physiotherapist recommend?

  1. Stairs should be avoided entirely at home
  2. The patient is ready for discharge without support
  3. The patient needs supervision on stairs for two weeks Correct answer.
  4. A hospital bed should be installed before discharge

Explanation

The physiotherapist confirms stair use with a rail but adds a condition of someone being present for the first fortnight, meaning supervision for two weeks. The word "but" signals the qualification attached to the patient's ability.

Question 4Listening

A ward nurse tells a colleague: "Bed four is nil by mouth from midnight, and theatre wants him first on the list." What must the nurse ensure for this patient?

  1. The patient has no food or drink before surgery Correct answer.
  2. The patient is given oral fluids hourly
  3. The patient's surgery is postponed to the afternoon
  4. The patient receives a light breakfast before transfer

Explanation

"Nil by mouth from midnight" means the patient must not eat or drink before the procedure, a standard preoperative instruction. Recognising this phrase is essential for patient safety during surgical preparation.

Question 5Listening

A nurse in a clinic says to a patient: "Your blood pressure is a little high today. I'll ask the doctor to see you before you leave." What is the nurse's immediate action?

  1. Arranging for the doctor to review the patient before departure Correct answer.
  2. Sending the patient home with no further review
  3. Booking the patient for a blood pressure check next month
  4. Prescribing medication to lower the blood pressure

Explanation

The nurse states an intention to have the doctor see the patient before leaving, which is the immediate action described. Nurses do not prescribe in this context, and no future appointment is arranged.

Question 6Listening

During a telephone call, a receptionist says: "The community midwife will visit on Thursday, and she'll bring the feeding pump then." What will happen on Thursday?

  1. The midwife phones to cancel the visit
  2. The midwife visits and supplies the feeding pump Correct answer.
  3. The patient attends the hospital for a scan
  4. The feeding pump is delivered by courier

Explanation

The receptionist states the midwife will visit on Thursday and will bring the feeding pump at that time. Both actions are linked to the same visit, so the correct answer combines them.

Question 7Listening

A doctor dictates: "Start her on IV antibiotics and repeat the bloods in six hours." Which instruction relates to monitoring the patient's response to treatment?

  1. Repeating the blood tests in six hours Correct answer.
  2. Admitting the patient to the ward
  3. Starting the IV antibiotics
  4. Referring the patient to the surgical team

Explanation

Repeating blood tests after a set interval is a monitoring action used to check how the patient is responding to treatment. Starting antibiotics is the intervention itself rather than the monitoring step.

Question 8Listening

A patient tells a nurse: "I'm fine, honestly. I just don't want to be a bother to anyone." What is the most likely underlying message?

  1. The patient is reluctant to ask for help Correct answer.
  2. The patient wants to be discharged today
  3. The patient is satisfied with the care received
  4. The patient is complaining about staff attitude

Explanation

The phrase "I don't want to be a bother" signals reluctance to request assistance rather than genuine contentment. Listening for such hedging language helps nurses identify unspoken needs.

Question 9Listening

In a team meeting, the nurse in charge says: "We're short-staffed tonight, so I'll move two nurses from the day shift to cover the late shift." What is the purpose of this statement?

  1. To request volunteers for the following week
  2. To explain a staffing adjustment for the evening Correct answer.
  3. To report that two nurses have resigned
  4. To announce that the ward will close overnight

Explanation

The nurse in charge links short staffing to moving two nurses onto the late shift, which is a staffing adjustment. The purpose is to inform the team how the evening will be covered.

Question 10Listening

A patient with diabetes says: "I check my sugars every morning, but I've been skipping lunch lately because of work." Which factor most likely affects the patient's glucose control?

  1. The patient's sleep position
  2. The type of glucose meter used
  3. The morning glucose checks
  4. Missing lunch on working days Correct answer.

Explanation

Skipping lunch can cause irregular glucose levels, especially for a patient on glucose-lowering treatment, so it is the factor most likely to affect control. The morning checks are a monitoring habit, not a cause of instability.

Question 11Listening

A nurse reports: "Mr Lee's wound is oozing a little, but the surrounding skin isn't red and he's afebrile." What is the nurse suggesting about the wound?

  1. There is no strong evidence of infection at present Correct answer.
  2. The dressing has not been changed recently
  3. The wound needs immediate surgical review
  4. There are clear signs of a spreading infection

Explanation

Absence of redness and fever alongside mild oozing suggests no strong signs of infection at this stage. The contrast word "but" separates the minor finding from the reassuring observations.

Question 12Listening

A doctor tells a nurse: "Give the antihistamine now, and if the rash spreads, page me straight away." What should the nurse do if the rash spreads?

  1. Record the change and take no action
  2. Wait until the next routine ward round
  3. Give a second dose of antihistamine
  4. Contact the doctor immediately Correct answer.

Explanation

The conditional instruction "if the rash spreads, page me straight away" requires the nurse to contact the doctor immediately. Conditional clauses in instructions define the trigger and the required response.

Question 13Listening

A patient says: "The tablets helped at first, but now I'm getting stomach cramps after taking them." What is the patient describing?

  1. An allergic reaction to the first dose
  2. A failure to take the tablets correctly
  3. An improvement in the original symptoms
  4. A possible side effect of the medication Correct answer.

Explanation

New stomach cramps appearing after starting a medication suggest a possible adverse effect rather than an allergy, which usually presents differently. The temporal link between taking the tablets and the cramps is the key listening cue.

Question 14Listening

A midwife says: "The baby fed well at 2 a.m., but has been sleepy and slow to wake for feeds since then." What change should the midwife be alert to?

  1. A normal pattern needing no review
  2. A faster than expected weight gain
  3. Improved feeding stamina
  4. Increased drowsiness and poor feeding Correct answer.

Explanation

A previously good feeder becoming sleepy and slow to feed is a change that warrants attention, as it may indicate illness in a newborn. The contrast between earlier feeding and the current pattern highlights the concern.

Question 15Listening

A nurse says to a colleague: "Mrs Patel's family want to speak to someone about her care, but they'd prefer it not to be during visiting hours." What do the family want?

  1. To complain about the ward's cleanliness
  2. To take over the patient's care decisions
  3. A meeting with staff outside visiting hours Correct answer.
  4. More frequent visiting times

Explanation

The family want to discuss care with staff but prefer a time outside visiting hours, so a meeting at another time is required. The "but" clause carries the specific preference.

Question 16Listening

In an emergency call, a paramedic says: "Patient's conscious but confused, pulse is fast and thready, and she's cool to touch." Which finding suggests poor peripheral circulation?

  1. The patient's age
  2. The patient being confused
  3. The fast, thready pulse Correct answer.
  4. The patient being conscious

Explanation

A fast, thready pulse together with cool skin indicates poor peripheral circulation and possible shock. Confusion is a neurological sign, while consciousness alone does not indicate circulatory status.

Question 17Listening

A nurse says: "I've escalated the concern twice, and I'm not getting a response from the registrar." What is the nurse's situation?

  1. The registrar has agreed to review the patient
  2. The escalation has not resulted in a reply Correct answer.
  3. The nurse has not yet reported the concern
  4. The concern has been resolved satisfactorily

Explanation

The nurse has escalated twice but received no response, so the escalation has not produced a reply. Recognising unmet escalation is important for patient safety and may require the nurse to escalate further up the chain.

Question 18Listening

A patient says: "I don't want my sister told anything about my results. She'll worry, and it's my business." How should the nurse interpret this?

  1. The patient wants the sister to be the main contact
  2. The patient is unsure who should be informed
  3. The patient wants the sister to collect the results
  4. The patient wishes to keep results confidential from the sister Correct answer.

Explanation

The patient explicitly states the sister should not be told anything, which is a request to maintain confidentiality. Nurses must respect the patient's wishes about sharing information with relatives.

Question 19Listening

A nurse manager says: "The audit showed we're documenting pain scores well, but our reassessment after analgesia is inconsistent." What does the manager identify as the main gap?

  1. Pain scores are rarely recorded
  2. Staff are not trained in pain assessment
  3. Analgesia is being given too frequently
  4. Follow-up assessment after pain relief is inconsistent Correct answer.

Explanation

The manager contrasts good initial pain scoring with inconsistent reassessment after analgesia, so the gap is follow-up assessment. The "but" clause identifies the specific weakness in practice.

Question 20Listening

A patient in a mental health unit says: "I'm not sleeping, and the voices are louder at night, so I stay awake to keep watch." What is the patient describing?

  1. A physical cause of insomnia such as pain
  2. A deliberate choice to avoid sleep for pleasure
  3. A side effect of a new medication
  4. Auditory hallucinations disturbing sleep Correct answer.

Explanation

The patient links louder voices at night to staying awake, indicating that auditory hallucinations are disrupting sleep. The nurse should record this as a symptom relevant to mental state and sleep assessment.

Question 21Listening

A doctor says: "Her potassium is 6.1, so I want a repeat sample and an ECG before we do anything else." Why is the doctor requesting an ECG?

  1. To check for cardiac effects of high potassium Correct answer.
  2. To assess the patient's lung function
  3. To prepare the patient for surgery
  4. To confirm the potassium result is accurate

Explanation

A potassium of 6.1 mmol/L is raised, and high potassium can affect cardiac conduction, so an ECG checks for cardiac effects. The repeat sample addresses accuracy, while the ECG assesses the heart.

Question 22Listening

A nurse says: "The family keep asking about the prognosis, but the consultant hasn't spoken to them yet, and I don't want to pre-empt her." What is the nurse's concern?

  1. The nurse should not disclose prognosis before the consultant does Correct answer.
  2. The consultant has already given a prognosis
  3. The family have refused to speak to the consultant
  4. The family do not want any information

Explanation

The nurse is reluctant to discuss prognosis because the consultant has not yet spoken to the family, so the concern is about avoiding disclosure ahead of the responsible clinician. This reflects role boundaries in communicating sensitive information.

Question 23Listening

A nurse reports: "He was alert at handover, but now he's only responding to pain, and his pupils are unequal." What does this combination most suggest?

  1. A need to repeat the observation in four hours
  2. The effects of a recent meal
  3. A normal variation in conscious level
  4. A deteriorating neurological state requiring urgent review Correct answer.

Explanation

A fall in conscious level with unequal pupils suggests a neurological deterioration that needs urgent assessment. Both findings together are red flags, and delay would be unsafe.

Question 24Listening

A patient says: "I know the surgery is meant to help, but if I'm honest, I'm terrified I won't wake up." What is the patient expressing?

  1. A complaint about the surgical team
  2. Confusion about the procedure date
  3. Fear about anaesthesia and survival Correct answer.
  4. A refusal to consent to surgery

Explanation

The patient acknowledges the intended benefit but admits fear of not waking up, which is anxiety about anaesthesia. The nurse should explore this concern and consider referral for preoperative support.

Question 25Listening

A nurse in a care home says: "She's been refusing food for three days, and her daughter says she's 'giving up'." What should the nurse prioritise in response?

  1. Waiting for the daughter to decide on treatment
  2. Respecting refusal without any further assessment
  3. Recording the refusal and reviewing in a week
  4. Assessing for reversible causes such as pain, depression or infection Correct answer.

Explanation

Persistent refusal of food warrants assessment for reversible causes such as pain, low mood, oral problems or infection before concluding the patient is "giving up". Acting on the daughter's interpretation alone risks missing treatable issues.

Question 26Listening

A district nurse leaves a voicemail for a colleague: "Mr Okafor's leg ulcer is bigger than last week and the surrounding skin is warm and red. I've started him on the compression regime we agreed, but I want you to review the wound tomorrow." Which part of this message is the main reason the nurse wants a review?

  1. The ulcer has enlarged and the skin around it is inflamed Correct answer.
  2. The wound dressing was last changed seven days ago
  3. The compression regime has already been started
  4. The patient lives alone and has limited mobility

Explanation

In OET Listening Part A, you must separate the key clinical finding from background detail. The change in wound size plus warmth and redness signals possible infection or deterioration, and that is the trigger for the requested review.

Question 27Listening

During a handover, a nurse says: "Mrs Bianchi had her PCA removed at 06:00 and she's now on oral analgesia. She's been up to the toilet twice with one assist and her last pain score was three out of ten." Which detail tells the listener that the patient's mobility has improved?

  1. She is now taking oral analgesia
  2. Her last pain score was three out of ten
  3. The PCA was discontinued at 06:00
  4. She has walked to the toilet twice with one assistant Correct answer.

Explanation

Mobility is described by what the patient physically did, so walking to the toilet with a single assistant is the mobility indicator. The other details concern analgesia route and pain intensity rather than movement.

Question 28Listening

A practice nurse is giving advice by phone: "Take the tablets with food, and if you miss a dose, take it as soon as you remember unless it's nearly time for the next one. Don't double up." What is the nurse's main purpose in this call?

  1. To confirm the patient has collected the prescription
  2. To explain how to take the medicine safely Correct answer.
  3. To arrange a follow-up appointment
  4. To record the patient's current symptoms

Explanation

The whole message concerns dosing instructions and what to do about a missed dose, so the purpose is safe administration advice. No symptoms are being assessed and no appointment is being booked.

Question 29Listening

A patient tells a triage nurse: "I've had this cough for about ten days. It's dry, and it's worse at night. I haven't had a temperature and I don't feel breathless." Which detail is most important for the nurse to record as a red flag that is absent?

  1. The cough is worse at night
  2. There is no breathlessness Correct answer.
  3. The cough is dry in character
  4. The cough has lasted ten days

Explanation

In respiratory triage, breathlessness is a key indicator of severity, so its absence is clinically significant and must be documented. Duration and character of the cough are descriptive but do not carry the same safety weight.

Question 30Listening

A nurse says to a patient: "Before we go any further, I want to check I've understood. You've told me the dizziness happens when you stand up, and that it started after your new blood pressure tablets. Is that right?" Why does the nurse summarise in this way?

  1. To end the consultation quickly
  2. To confirm the history is accurate before continuing Correct answer.
  3. To test whether the patient has understood the medication leaflet
  4. To persuade the patient to change medication

Explanation

Summarising and checking back is a standard communication technique used to verify that the recorded history matches what the patient intended to convey. It protects against misunderstandings before care decisions are made.

Question 31Listening

A ward nurse tells a colleague: "Mr Haddad's daughter rang. She says he's been more forgetful since discharge and she's worried about leaving him alone. She asked whether the memory clinic referral has gone through." What does the daughter most want to know?

  1. Whether she can take her father home for the weekend
  2. Whether her father needs a new prescription
  3. Whether the memory clinic referral has been sent Correct answer.
  4. Whether the ward can arrange transport

Explanation

The daughter's explicit question is about the status of the memory clinic referral, so that is her primary concern. Her worry about leaving him alone is context, not the question she asked.

Question 32Listening

During a consultation, a GP says: "Your HbA1c has come down from 74 to 58 since we started the new tablet. I'm happy with that, so let's keep everything as it is and see you in six months." What does the GP decide?

  1. To stop the tablet and monitor diet alone
  2. To increase the dose of the current tablet
  3. To continue the current plan unchanged Correct answer.
  4. To bring the review forward to three months

Explanation

The GP states satisfaction with the improvement and says to keep everything as it is, which means no change to treatment. The review interval is also stated as six months.

Question 33Listening

A nurse manager tells the team: "From Monday, all patients on the falls pathway will have a bed sensor fitted at admission, not after the first fall. Physio will review anyone with a previous fall within 24 hours." What is the main change being introduced?

  1. Bed sensors will be fitted earlier in the admission Correct answer.
  2. Falls incidents will no longer be reported
  3. The falls pathway will be withdrawn
  4. Physiotherapy will stop reviewing fall patients

Explanation

The manager contrasts fitting the sensor at admission with the previous practice of waiting until after a fall, so the change is earlier intervention. Physiotherapy review is being strengthened, not removed.

Question 34Listening

A patient says to a nurse: "I've been reading about the operation online and I'm not sure I want to go ahead. The surgeon said it would help, but I keep thinking about what could go wrong." What is the patient mainly expressing?

  1. Fear about the risks of surgery Correct answer.
  2. Confusion about the date of the operation
  3. Dissatisfaction with the nursing care
  4. A wish to change surgeon

Explanation

The patient describes persistent worry about what could go wrong, which is anxiety about surgical risk. No concern is raised about dates, nursing care, or the surgeon's competence.

Question 35Listening

A doctor tells a nurse on the phone: "I'm stuck in theatre for another hour. Can you get the chest X-ray done and put the request in for the surgical review, but don't send him to theatre until I've seen him?" Which action should the nurse take first?

  1. Arrange the chest X-ray request Correct answer.
  2. Book the patient for theatre
  3. Cancel the surgical review
  4. Wait for the doctor to call back

Explanation

The doctor gives two tasks and one restriction; the immediate tasks are to arrange the X-ray and request the surgical review, and the restriction is that theatre must wait. Arranging the X-ray is the first concrete task listed and can proceed without delay.

Question 36Listening

A nurse asks a patient: "Have you had any bleeding between your periods, or any discharge that's new for you?" The patient replies: "No bleeding, no. Well, once, about a month ago, but I didn't think it counted." How should the nurse treat this answer?

  1. As a negative response that needs no recording
  2. As a positive symptom that must be documented Correct answer.
  3. As a reason to end the consultation
  4. As an unreliable answer that should be ignored

Explanation

The patient initially denies bleeding but then discloses an episode, so the accurate history is that post-coital or intermenstrual bleeding occurred once. Any bleeding between periods is clinically relevant and must be recorded.

Question 37Listening

In a multidisciplinary meeting, a physiotherapist says: "I don't think Mr Clarke is safe on the stairs yet, but the family are keen for discharge on Friday. I'd rather we waited another week and involved the occupational therapist." What is the physiotherapist recommending?

  1. A short delay with occupational therapy input Correct answer.
  2. Immediate discharge to a care home
  3. Transfer to a rehabilitation unit
  4. Discharge on Friday with family support

Explanation

The physiotherapist expresses doubt about safety, prefers to wait a week, and wants occupational therapy involved, which amounts to a short delay with further assessment. The family's wish is reported but not endorsed.

Question 38Listening

A midwife says on the phone: "I'm with a woman at 38 weeks who says the baby has stopped moving since yesterday. She's not bleeding and her waters haven't gone. I'm bringing her in; can you alert the labour ward?" What is the most urgent reason for transfer?

  1. The baby has not moved since yesterday Correct answer.
  2. The woman has no vaginal bleeding
  3. The woman is 38 weeks pregnant
  4. The membranes are intact

Explanation

Reduced fetal movements are a recognised reason for urgent assessment because they can indicate fetal compromise, so this is the priority concern. Gestational age and the absence of bleeding or ruptured membranes are reassuring but secondary.

Question 39Listening

A nurse records: "Mr Adeyemi's wife does most of his insulin injections because he says his hands shake too much to draw up the dose. He is reluctant to ask the district nurse for help." What is the main risk the nurse should address?

  1. The patient may be eating too much at mealtimes
  2. The patient may be using the wrong insulin type
  3. The patient may be allergic to insulin
  4. The patient may miss doses when his wife is unavailable Correct answer.

Explanation

The concern is that a third party administers the insulin while the patient is unwilling to seek professional support, so doses could be missed if she is not there. Nothing in the statement suggests a wrong insulin type, dietary excess, or allergy.

Question 40Listening

A nurse in a clinic says to a colleague: "Mrs Nowak keeps apologising for taking up my time and asks whether she's 'allowed' to ask questions. She's asked three times whether the biopsy will hurt." What should the colleague infer about Mrs Nowak?

  1. She wants to cancel the biopsy
  2. She is angry about the waiting time
  3. She feels anxious and unsure she is entitled to information Correct answer.
  4. She has forgotten why she attended

Explanation

Repeated apologies, asking permission to ask questions, and repeated questions about pain point to anxiety and a sense of not being entitled to information. There is no expression of anger or wish to cancel.

Question 41Listening

A nurse says: "I've checked the controlled drugs cupboard against the register twice and the count is short by two tablets of oxycodone. The last entry was signed by a bank nurse on Saturday." What should happen next?

  1. The cupboard should be locked and left until Monday
  2. The count should be adjusted to match the register
  3. The bank nurse should be dismissed without further inquiry
  4. The discrepancy should be reported and investigated immediately Correct answer.

Explanation

A controlled drug discrepancy is a serious governance issue requiring immediate reporting and investigation under local policy. Adjusting records or delaying action would breach accountability, and dismissal before investigation would be unjustified.

Question 42Listening

A patient in a respiratory ward tells a nurse: "The physio showed me the breathing exercises, but I can't manage them when I'm this breathless, and my husband does everything for me at home anyway." What does the patient's statement most suggest?

  1. A dislike of the physiotherapist
  2. A wish to be discharged early
  3. The exercises were taught incorrectly
  4. Low confidence and possible dependence on her husband Correct answer.

Explanation

The patient links her inability to practise with breathlessness and mentions her husband doing everything, which points to low self-efficacy and dependence. There is no criticism of the teaching or the physiotherapist and no discharge request.

Question 43Listening

A nurse tells a colleague: "The consultant has asked us to use the new sepsis screening tool for every admission, but the ward clerk hasn't been trained on it and the IT system still has the old form." What does this reveal about implementing the change?

  1. There are practical barriers to using the tool Correct answer.
  2. The consultant has withdrawn the request
  3. The tool has been fully embedded in practice
  4. The ward clerk is responsible for screening

Explanation

Missing training and an outdated electronic form are practical obstacles that could prevent staff from completing the screening. The consultant's request still stands and screening remains a clinical task.

Question 44Listening

A doctor dictates: "Please refer Mrs Kowalski to the continence team, and note that she's had three urinary tract infections in six months, all confirmed on culture. She's currently on her second course of trimethoprim." Which detail supports the referral?

  1. She has been seen by the continence team before
  2. She has had three culture-confirmed urinary infections in six months Correct answer.
  3. She has no urinary symptoms at present
  4. She is currently taking trimethoprim

Explanation

Recurrent, culture-confirmed urinary tract infections are the clinical grounds for continence referral. The current antibiotic course is treatment detail rather than the indication.

Question 45Listening

A nurse is taking a history from a man with chest pain: "The pain came on while I was mowing the lawn and eased after about five minutes' rest. I've had it twice this week doing the same thing." What pattern does this describe?

  1. Pain that only occurs at night
  2. Exertional pain relieved by rest, occurring repeatedly Correct answer.
  3. Pain that is constant and unrelated to exertion
  4. Pain associated with eating

Explanation

Pain provoked by exertion and relieved by rest, recurring with the same trigger, is the classic pattern of stable angina. Constant pain, nocturnal pain, and meal-related pain describe different patterns.

Question 46Listening

A nurse in a memory clinic hears a carer say: "Mum's fine in the mornings, but from about four o'clock she gets agitated and keeps asking to go home, even though she's in her own house. It's worse on the days she's had little sleep." What is the nurse hearing described?

  1. A side effect of the memory clinic appointment
  2. Late-day agitation with a possible link to poor sleep Correct answer.
  3. A predictable delirium unrelated to time of day
  4. A deliberate attempt to upset the carer

Explanation

Agitation that worsens in the late afternoon and evening, with a reported association with poor sleep, fits a late-day behavioural pattern sometimes called sundowning. The account does not describe a deliberate behaviour or an appointment effect.

Question 47Listening

A nurse says to a colleague: "I explained the dressing change to Mr Silva and he nodded, but when I asked him to repeat the steps back he described soaking the wound in the bath." What should the nurse conclude?

  1. The patient understood and can follow the plan
  2. The patient's understanding is incomplete and needs re-teaching Correct answer.
  3. The patient is deliberately being difficult
  4. The patient should be discharged without further teaching

Explanation

Nodding does not confirm comprehension; the teach-back reveals a misunderstanding, so the nurse must re-teach and recheck. The error is a gap in understanding rather than wilful non-compliance.

Question 48Listening

During a rapid response call, a nurse reports: "He became drowsy over about twenty minutes, his respiratory rate is eight, and he's had morphine and a sedative in the last hour." What is the most likely explanation the team should consider first?

  1. A urinary tract infection
  2. A hypoglycaemic episode
  3. An allergic reaction to the sedative
  4. Cumulative sedation from recent opioid and sedative doses Correct answer.

Explanation

Progressive drowsiness with a low respiratory rate shortly after an opioid and a sedative strongly suggests drug-induced respiratory depression. Allergy would usually show rash, swelling, or wheeze, and infection or hypoglycaemia would not explain the timing so directly.

Question 49Listening

A nurse manager says: "Our compliance with the pressure ulcer bundle is 60 per cent, but when I looked at the figures, the night staff aren't documenting repositioning even though they're doing it. The day staff document well but turn patients less often." What is the key problem?

  1. The bundle should be abandoned
  2. Night staff are not repositioning patients
  3. Documentation and practice are each accurate but incomplete Correct answer.
  4. Day staff should take over all repositioning

Explanation

The manager identifies a documentation gap at night and a practice gap during the day, so the recorded compliance figure does not reflect actual care. The remedy is to address both gaps separately, not to abandon the bundle.

Question 50Listening

A patient with a new stoma tells a nurse: "Everyone keeps telling me it'll be fine and that I'll get used to it. Nobody actually shows me how to change the bag without it leaking." What does the patient most need?

  1. To be told the stoma will be reversed
  2. A referral for psychological therapy as the first step
  3. Practical, hands-on stoma care teaching Correct answer.
  4. More reassurance that everything will be fine

Explanation

The patient explicitly contrasts vague reassurance with a lack of practical instruction, so the priority is hands-on teaching of bag changes. Reassurance has already been offered and has not met the need.