Free NMC Test of Competence OSCE: Adult Nursing Exam Questions and Answers

Correct answer: Marking criteria: Explains the procedure to the patient and gains consent. Assembles equipment required and checks equipment is sterile; takes the equipment to the bedside on trolley. Ensures patient is supine with knees bent, hips flexed and feet apart. Cleans hands (alcohol rub or soap and water, WHO guidelines). Dons disposable plastic apron. Using aseptic non-touch technique, opens sterile pack and places sterile equipment onto the sterile field. Dons sterile gloves; places sterile towel under buttocks. Uses non-dominant hand to separate labia and gauze swabs soaked in sodium chloride 0.9% to clean urethral orifice using downward strokes, not touching surrounding skin. Applies anaesthetic lubrication to the meatus, inserts nozzle of syringe into urethra and instils gel. Places catheter, in sterile receiver, between patient's legs and attaches drainage bag. Uses dominant hand to introduce catheter tip into urethral orifice in an upward and backward direction; advances until urine is draining and up to the bifurcation point. Cautiously inflates balloon with prefilled syringe of water for injection, noting pain or discomfort. Gently withdraws catheter slightly until resistance is felt. Assists in cleaning patient and disposing of equipment. Supports catheter with a specially designed support (such as Simpla G-Strap) without occluding the lumen; ensures drainage bag is supported and secure, port away from floor. Cleans hands. States would document reasons for catheterisation, time and date, catheter type, length and size, batch number and manufacturer. States would measure and record urine output. Acts professionally in accordance with NMC (2018) The Code.

Correct answer: Marking criteria: Introduces self. Explains procedure to the person and gains consent. Ensures that the patient is in a comfortable and suitable position where they are able to watch the procedure. Checks all equipment required for the procedure, including expiry dates: new colostomy bag, a disposable bag, gauze, scissors and a receptacle are needed. Cleans hands with alcohol rub or washes with soap and water and dries with paper towels according to the WHO guidelines. Dons a disposable plastic apron and non-sterile gloves. Places a small protective disposable pad below the stoma area to protect patient’s clothes from accidental spillage. Removes the stoma bag slowly using adhesive remover. Peels the adhesive off the skin while using the opposite hand to apply pressure on the surrounding skin. Folds the removed stoma bag to prevent spillage before placing into a disposable bag. Removes any visible faeces or mucus from the stoma with a piece of gauze soaked in warm tap water. Examines the stoma site and peristomal skin for soreness, ulceration, signs of infection and other unusual signs such as unusual site colour (black or pale), foul odour or discharge. Washes the skin around the stoma (peristomal area) with gauze soaked in warm tap water. Gently dries the peristomal skin with dry gauze, ensuring that the area is thoroughly dry. Measures the stoma site, cuts a hole in the adhesive flange of the new bag, aiming for 3mm larger than the site. Applies the clean appliance, using the flat of hand to gently press to ensure it adheres in all areas. Disposes of equipment including apron and gloves appropriately – verbalisation accepted. Cleans hands with alcohol rub or washes with soap and water and dries with paper towels according to the WHO guidelines. States would document the change of stoma bag in nursing notes and would report any abnormalities to the stoma nurse and/or surgical team. Acts professionally throughout procedure in accordance with NMC (2018) ‘The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates’.

Correct answer: Marking criteria: Explains the procedure to the patient and gains consent. Assembles equipment required and checks equipment is sterile; takes the equipment to the bedside on trolley. Ensures patient is supine with knees bent, hips flexed and feet apart. Cleans hands (alcohol rub or soap and water, WHO guidelines). Dons disposable plastic apron. Using aseptic non-touch technique, opens sterile pack and places sterile equipment onto the sterile field. Dons sterile gloves; places sterile towel under buttocks. Uses non-dominant hand to separate labia and gauze swabs soaked in sodium chloride 0.9% to clean urethral orifice using downward strokes, not touching surrounding skin. Applies anaesthetic lubrication to the meatus, inserts nozzle of syringe into urethra and instils gel. Places catheter, in sterile receiver, between patient's legs and attaches drainage bag. Uses dominant hand to introduce catheter tip into urethral orifice in an upward and backward direction; advances until urine is draining and up to the bifurcation point. Cautiously inflates balloon with prefilled syringe of water for injection, noting pain or discomfort. Gently withdraws catheter slightly until resistance is felt. Assists in cleaning patient and disposing of equipment. Supports catheter with a specially designed support (such as Simpla G-Strap) without occluding the lumen; ensures drainage bag is supported and secure, port away from floor. Cleans hands. States would document reasons for catheterisation, time and date, catheter type, length and size, batch number and manufacturer. States would measure and record urine output. Acts professionally in accordance with NMC (2018) The Code.

Correct answer: Marking criteria: Introduces self. Explains procedure to the person and gains consent. Ensures that the patient is in a comfortable and suitable position where they are able to watch the procedure. Checks all equipment required for the procedure, including expiry dates: new colostomy bag, a disposable bag, gauze, scissors and a receptacle are needed. Cleans hands with alcohol rub or washes with soap and water and dries with paper towels according to the WHO guidelines. Dons a disposable plastic apron and non-sterile gloves. Places a small protective disposable pad below the stoma area to protect patient’s clothes from accidental spillage. Removes the stoma bag slowly using adhesive remover. Peels the adhesive off the skin while using the opposite hand to apply pressure on the surrounding skin. Folds the removed stoma bag to prevent spillage before placing into a disposable bag. Removes any visible faeces or mucus from the stoma with a piece of gauze soaked in warm tap water. Examines the stoma site and peristomal skin for soreness, ulceration, signs of infection and other unusual signs such as unusual site colour (black or pale), foul odour or discharge. Washes the skin around the stoma (peristomal area) with gauze soaked in warm tap water. Gently dries the peristomal skin with dry gauze, ensuring that the area is thoroughly dry. Measures the stoma site, cuts a hole in the adhesive flange of the new bag, aiming for 3mm larger than the site. Applies the clean appliance, using the flat of hand to gently press to ensure it adheres in all areas. Disposes of equipment including apron and gloves appropriately – verbalisation accepted. Cleans hands with alcohol rub or washes with soap and water and dries with paper towels according to the WHO guidelines. States would document the change of stoma bag in nursing notes and would report any abnormalities to the stoma nurse and/or surgical team. Acts professionally throughout procedure in accordance with NMC (2018) ‘The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates’.

Correct answer: Recognises that taking NHS/hospital property for personal use or gain, including medication, is prohibited. Recognises professional duty to report any concerns that may result in compromising the safety of patients in their care or the public, and that failure to report concerns may bring their own fitness to practise into question and place own registration at risk. Raises concern with manager at the earliest opportunity, verbally or in writing; is clear, honest and objective about the reasons for concern, reflecting duty of candour. Recognises that the manager may wish an incident report to be completed, recording the events, steps taken to deal with the matter including the date, and with whom the concern was raised. Takes into consideration own responsibility for the safety of the colleague, and considers the effects of codeine on their ability to work and drive home. Considers that the colleague may need a medical review for their headache or may need support in dealing with a substance misuse problem. Acknowledges the need to keep to and uphold the standards and values set out in ‘The Code’: prioritise people, practise effectively, preserve safety and promote professionalism and trust. Handwriting is clear and legible.

Correct answer: Summarises the main findings from the article summary and draws conclusions, making recommendations for practice. Writes clearly and legibly. Informs Mrs Green that it is very common for patients to experience sleep deprivation in ICU. Explains that the disturbances in sleep may continue for several months after discharge. Explains that the nature of a patient’s illness, previous sleep experience and severity of illness may influence sleep pattern. Informs Mrs Green that noise, light, pain, anxiety, nursing interventions, diagnostic tests, medications and non-invasive ventilation may have impacted her sleep. Discusses with Mrs Green any feelings of pain or anxiety that may have impacted her sleep. Invites Mrs Green back in 2 or 3 months’ time for follow-up support.