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Question 1 of 29
CBT PA010
Convert 1500 micrograms to milligrams. What is the value in mg?
Give your answer in mg.
Not this time
Why
1000 micrograms = 1 mg. Therefore 1500 micrograms = 1500 ÷ 1000 = 1.5 mg.
NMC Standards of Proficiency
CBT PA074
Child 22 kg prescribed 5 mg/kg. Available: 250 mg/5 mL. What volume?
Give your answer in mL.
Not this time
Why
Dose = 5 x 22 = 110 mg. Volume = (110/250) x 5 = 550/250 = 2.2 mL.
BNF
CBT PA063
A patient is prescribed paracetamol 1 g four times a day. The tablets available are 500 mg. How many tablets will they take in 24 hours?
Give your answer in tablets.
Not this time
Why
Calculation: 1 g is two 500 mg tablets, and four doses of two is 8 tablets. That is 4 g in 24 hours, the maximum for an adult, so any further paracetamol in a combination product would take them over it.
BNF
CBT PA040
A patient is prescribed 450 mg of cefuroxime IV. The vial contains 750 mg of cefuroxime powder. After reconstitution with 6 mL water for injection, what volume in mL should be drawn up? (Give answer to one decimal place.)
Give your answer in mL.
Not this time
Why
Concentration = 750 ÷ 6 = 125 mg/mL. Volume needed = 450 ÷ 125 = 3.6 mL.
BNF, NMC Standards of Proficiency
CBT PA072
500 mL via micro-drip set (60 drops/mL) over 6 hours. Drip rate in drops/min, to the nearest whole number?
Give your answer in drops/min.
Not this time
Why
(500 x 60) / (6 x 60) = 30000/360 = 83.33, rounds to 83.
NMC Standards
CBT PA060
Intake: IV 800 mL, oral 600 mL. Output: urine 1000 mL, drain 100 mL, insensible 400 mL. Balance in mL?
Give your answer in mL.
Not this time
Why
In = 1400. Out = 1500. Balance = -100 mL.
NMC Standards
CBT NQ4423
A staff nurse recovering from a fractured distal radius is capable of clinical triage, patient education, and computer documentation, but is temporarily prohibited from manual handling and bedside hoisting. Which formal adjustment to working arrangements does this represent?
Select one answer.
Not this time
Why
Temporarily removing high-risk tasks such as manual handling while retaining other clinical responsibilities constitutes amended duties. Workplace adaptations would instead involve physical alterations to the working environment or providing ergonomic equipment to enable existing duties to continue.
NMC Standards of Proficiency Platform 1
CBT NQ4315
A health visitor conducts a home consultation for a mother experiencing mild postnatal depression and difficulties establishing infant sleep routines. The health visitor implements targeted, short-term expert support to assist the mother with these specific concerns. Which level of support within the 4-tier Healthy Child Programme does this intervention represent?
Select one answer.
Not this time
Why
Universal Plus level support is defined by the delivery of time-limited, targeted expert intervention for identified additional needs such as mild postnatal depression and sleep problems. Universal Partnership Plus would be required if there were complex continuous safeguarding concerns or a child protection plan.
NMC Standards of Proficiency Platform 2
CBT NQ4939
A 52-year-old man who became profoundly deaf following adult meningitis attends a pre-operative assessment clinic. He communicates exclusively in English, does not use lipreading or sign language, and requests real-time verbatim text displayed on a portable monitor to follow the consultation. Which communication professional represents the appropriate reasonable adjustment under the Equality Act 2010?
Select one answer.
Not this time
Why
A patient who communicates in English without using lipreading or sign language requires a registered speech-to-text reporter for real-time verbatim captioning. A registered lipspeaker would be required if the patient communicated in English through lipreading.
NMC Standards of Proficiency Platform 3
CBT NQ5109
A 56-year-old man with long-standing diabetes attends the chronic disease management clinic. He describes burning, lancinating, electric-shock sensations in both feet accompanied by allodynia and hyperalgesia. Which classification of pain is this patient experiencing?
Select one answer.
Not this time
Why
Burning, lancinating sensations accompanied by allodynia and hyperalgesia are classical features of neuropathic pain secondary to peripheral nerve pathology. Somatic nociceptive pain would be identified by well-localised, aching, or sharp pain related to musculoskeletal injury without autonomic or neuropathic characteristics.
NMC Standards of Proficiency Platform 4
CBT NQ5724
A 58-year-old woman recovering from major abdominal surgery develops new-onset tachypnoea, tachycardia, and a mild temperature rise. The nurse needs to objectively quantify her physiological deterioration to determine escalation urgency. Which clinical assessment tool should the nurse complete?
Select one answer.
Not this time
Why
Calculating the National Early Warning Score 2 objectively grades physiological derangement across multiple vital signs to trigger the correct clinical escalation pathway. The 4AT rapid assessment tool would instead be selected if the patient presented with acute confusion, fluctuating alertness, and agitation suggestive of delirium.
NMC Standards of Proficiency Platform 5
CBT NQ4593
A 38-year-old male patient on an acute medical ward develops an unexpected, life-threatening anaphylactic reaction following administration of a newly licensed intravenous antimicrobial agent with no previous allergy recorded. Which regulatory reporting scheme must the staff nurse complete to notify UK medicine safety regulators of this adverse event?
Select one answer.
Not this time
Why
The MHRA Yellow Card scheme is the statutory UK system for reporting suspected adverse drug reactions, particularly serious reactions to newly licensed black triangle medications. Care Quality Commission Regulation 18 notifications are submitted for serious injuries resulting from care delivery, while Section 42 referrals address adult safeguarding concerns.
NMC Standards of Proficiency Platform 6
CBT NQ5218
A 24-year-old patient admitted to a general medical ward with acute diabetic ketoacidosis discloses active suicidal ideation during a nursing review and requires urgent psychiatric evaluation within the physical hospital setting. Which specialist service should the staff nurse contact?
Select one answer.
Not this time
Why
The need for urgent psychiatric evaluation within a physical acute hospital setting determines referral to the Psychiatric Liaison Team. The Crisis Resolution and Home Treatment Team would be appropriate if the person were in the community requiring intensive home visits to avoid admission.
NMC Standards of Proficiency Platform 7
CBT NQ4766
A 58-year-old man recovering from an acute stroke presents with expressive aphasia alongside preserved intellectual capacity. To involve him directly in care planning, the nurse uses written keywords, simple drawings, and gestures to verify comprehension. Which alternative communication technique is the nurse employing?
Select one answer.
Not this time
Why
Supported Conversation for Aphasia utilises multimodal visual scaffolding such as keywords, sketches, and gesturing to unlock retained competence in adults with aphasia. The Picture Exchange Communication System would instead involve handing over discrete picture cards to make requests, typically in non-verbal autism.
NMC Standards of Proficiency Annexe A
CBT NQ5527
A 42-year-old man receiving ongoing treatment with haloperidol on a psychiatric intensive care unit insidiously develops severe lead-pipe rigidity, hyperthermia, altered consciousness, and elevated creatine kinase. Which adverse medication reaction should the nurse suspect?
Select one answer.
Not this time
Why
The combination of haloperidol therapy, lead-pipe muscle rigidity, hyperthermia, and raised creatine kinase is diagnostic of neuroleptic malignant syndrome. Serotonin syndrome presents with hyperreflexia and clonus rather than lead-pipe rigidity, usually following serotonergic drug escalation.
NMC Standards of Proficiency Annexe B
CBT PA088
Convert 0.06 g to micrograms.
Give your answer in micrograms.
Not this time
Why
0.06 g = 60 mg = 60000 micrograms.
BNF
CBT PA076
Patient weighs 82 kg and is 1.68 m tall. BMI to 1 decimal place?
Give your answer in kg/m².
Not this time
Why
BMI = 82 / (1.68 x 1.68) = 82 / 2.8224 = 29.1.
NICE CKS
CBT PA089
Prescribed: 250 mg amoxicillin. Available: 125 mg/5 mL suspension. Volume?
Give your answer in mL.
Not this time
Why
(250/125) x 5 = 10 mL.
BNF
CBT PA058
A patient needs 0.9% NaCl 1500 mL over 12 hours. Rate in mL/hour?
Give your answer in mL/hour.
Not this time
Why
1500 / 12 = 125 mL/hour.
NMC Standards
CBT NQ268
Over 12 hours a patient takes 1200 mL of fluid, passes 900 mL of urine and vomits three times, measured as 250 mL, 175 mL and 300 mL. What is their fluid balance in mL?
Give your answer in mL.
Not this time
Why
Output is 900 mL of urine plus 725 mL of vomit, which is 1625 mL against an intake of 1200 mL, so the balance is minus 425 mL. Vomit is an output nobody prescribes and is the column most often left blank, which turns a negative balance into a positive one on paper.
NMC Standards of Proficiency Annexe B
CBT NQ4476
In the emergency department, a nurse relies disproportionately on an initial triage handover of alcohol intoxication, failing to revise the working diagnosis when new focal neurological deficits emerge during observation. Which cognitive bias is demonstrated in this clinical assessment?
Select one answer.
Not this time
Why
The decisive fact is the failure to adjust initial impressions despite subsequent conflicting clinical findings, which constitutes anchoring bias. Availability bias would involve estimating diagnostic probability based on memorable recent encounters.
NMC Standards of Proficiency Platform 1; NMC Code (2018)
CBT NQ4268
A 48-year-old man attending an annual health review discusses his ongoing cigarette smoking. During the discussion, the patient is in the contemplation stage of change, verbally oscillating between the perceived benefits and drawbacks of continuing an unhealthy lifestyle habit. Which communication strategy should the nurse use?
Select one answer.
Not this time
Why
Weighing the positive and negative aspects of an unhealthy habit while in the contemplation stage specifically calls for decisional balance exploration. Importance and confidence scaling would instead be indicated if the patient considered change desirable but felt uncertain about their personal ability to succeed.
NICE PH49: Behaviour change: individual approaches
CBT NQ5000
A 42-year-old man is brought to the emergency department after ingesting an excess of amitriptyline. On initial nursing assessment, he exhibits acute confusion, dilated sluggish pupils, dry flushed skin, reduced bowel sounds, urinary retention, and a heart rate of 128 beats per minute. Which toxidrome do these assessment findings indicate?
Select one answer.
Not this time
Why
The combination of acute confusion, sluggish mydriasis, dry flushed skin, decreased bowel sounds, urinary retention, and tachycardia following tricyclic antidepressant overdose represents an anticholinergic toxidrome. A cholinergic toxidrome would present with salivation, lacrimation, diarrhoea, and bradycardia.
NMC Standards of Proficiency Platform 3
CBT NQ5170
A community nurse is dressing an open surgical wound on an adult patient's abdomen. Assessment reveals a moderately-to-heavily exuding cavity wound requiring a conformable calcium-ion-donating primary dressing to absorb exudate and form a gel. Which dressing is indicated?
Select one answer.
Not this time
Why
The combination of cavity presentation with moderate-to-heavy exudate requiring calcium ion donation to create a gel indicates an alginate dressing. A hydrocolloid is unsuitable for deep or heavily exuding cavities, and hydrogel sheets donate water rather than absorb moderate-to-heavy cavity exudate.
National Wound Care Strategy Programme (NHS England)
CBT NQ5782
A 68-year-old patient recovering from an acute ischaemic stroke is now medically stable and preparing for discharge home. Which interdisciplinary team member should be requested to assess functional independence in washing and dressing, and provide adaptive equipment?
Select one answer.
Not this time
Why
The assessment of functional independence in activities of daily living such as washing and dressing, along with the provision of adaptive equipment, sits within the distinct scope of practice of an occupational therapist. A physiotherapist would be indicated instead if the primary requirement were chest clearance or physical mobility rehabilitation.
NMC Standards of Proficiency Platform 5
CBT NQ4653
A 68-year-old man recovering from a femoral nerve block is admitted to a neuro-rehabilitation unit to begin mobility retraining. The adult inpatient on a rehabilitation ward requires a validated numerical scoring assessment of gait disturbance, secondary diagnoses, and use of ambulatory aids to predict inpatient slip and trip risk. Which validated assessment tool should the nurse complete?
Select one answer.
Not this time
Why
A scoring tool that specifically assigns numerical values to gait disturbance, secondary diagnoses, and ambulatory aid use is the Morse Fall Scale. The Stratify Falls Risk Score would instead be indicated if the unit required a five-item tool focusing specifically on visual impairment, agitation, toileting frequency, transfer ability, and fall history.
NMC Standards of Proficiency Platform 6
CBT NQ5287
A 54-year-old woman attending an outpatient oncology clinic has acquired profound hearing loss, communicates fluently in spoken English, and does not use sign language. She requests a communication professional who will silently repeat spoken words with exaggerated lip patterns and facial expressions to facilitate the discussion. Which specialist communication support professional should the nurse book?
Select one answer.
Not this time
Why
The request for an accredited professional to silently repeat spoken words with exaggerated lip patterns and facial expressions uniquely indicates a professional lipspeaker. A British Sign Language interpreter would be required if the patient communicated primarily through sign language rather than spoken English.
NMC Standards of Proficiency Platform 7
CBT NQ4827
A community nurse visits a 62-year-old woman with established, symptomatic peripheral arterial disease to provide structured foot care and supervised exercise therapy aimed at limiting functional mobility loss and preventing ischaemic ulcers. Which level of prevention does this nurse's intervention represent?
Select one answer.
Not this time
Why
Providing interventions to an individual with an established, symptomatic disease to prevent deterioration, functional impairment, and secondary complications defines tertiary prevention. Primary prevention would instead involve intervening before the onset of disease in an individual with risk factors.
NMC Standards of Proficiency Annexe A
CBT NQ5607
A registered nurse on an oncology day unit is preparing to connect and administer an intravenous bolus infusion of a cytotoxic antineoplastic agent to an adult patient. Which hand protection is specifically indicated for this clinical procedure?
Select one answer.
Not this time
Why
The safe handling and administration of cytotoxic antineoplastic medications requires chemical-tested, double-layered purple nitrile chemotherapy gloves to protect against permeation. Standard nitrile examination gloves are indicated only for non-hazardous tasks such as routine venepuncture.
NMC Standards of Proficiency Annexe B