Free NMC Test of Competence OSCE: Children's Nursing Exam Questions and Answers

Correct answer: Planning criteria: Clearly and legibly handwrites answers. Identifies two relevant nursing family/child-centred care problems/needs. Identifies aims for both problems. Sets appropriate evaluation date for both problems. Ensures nursing and family/child interventions are current/evidence-based/best practice. Uses professional terminology in care planning. Does not use abbreviations or acronyms. Ensures strike-through errors retain legibility. Accurately prints, signs and dates (when required). Acts professionally in accordance with NMC (2018) The Code.

Correct answer: Evaluation criteria (SBAR handover): Situation: introduces self and clinical setting; states patient's name, hospital number and/or date of birth, and location; states reason for handover. Background: states date of admission/reason for admission/referral and diagnosis; notes previous medical history and relevant medication/social history; gives details of current events and findings from assessment. Assessment: states most recent observations, results and changes; identifies main nursing family/child-centred care problems/needs; states nursing and medical interventions completed; states areas of concerns. Recommendation: states what is required of the person taking the handover and proposes a realistic plan of action. Overall: verbal communication clear and appropriate; systematic and structured approach; acts professionally in accordance with NMC (2018) The Code.

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 person's bedside on trolley. Ensures that the patient is in a supine position with knees bent, hips flexed and feet apart. Cleans hands with alcohol hand rub, or washes with soap and water and dries with paper towels following WHO guidelines – verbalisation accepted. Dons a disposable plastic apron. Using an aseptic non-touch technique, opens the sterile pack and places the rest of the sterile equipment onto the sterile field. Dons sterile gloves. Places a sterile towel under the patient's buttocks. Uses non-dominant hand to separate labia and uses gauze swabs soaked in sodium chloride 0.9% to clean the urethral orifice using downward strokes, being careful not to touch surrounding skin. Applies anaesthetic lubrication to the meatus and gently inserts nozzle of anaesthetic syringe into urethra, and then instils gel into the urethra. Places the catheter, in the sterile receiver, between the patient's legs and attaches the drainage bag. Uses dominant hand to introduce the tip of the catheter into the urethral orifice in an upward and backward direction. Advances the catheter until urine is draining and up to the bifurcation point (junction of the catheter/balloon inflation tubing). Cautiously inflates the catheter balloon with prefilled syringe containing water for injection, noting any pain or discomfort. Gently withdraws the catheter slightly, until resistance is felt. Assists in cleaning the patient and disposing of equipment. Supports the catheter using a specially designed support (such as Simpla G-Strap), ensuring that the catheter lumen is not occluded by the fixation device. Ensures drainage bag is supported and secure, with the drainage port away from the floor. Cleans hands with alcohol hand rub, or washes with soap and water and dries with paper towels following WHO guidelines – verbalisation accepted. States would document the reasons for catheterisation, time and date of catheterisation, catheter type, length and size, batch number and manufacturer. States would measure and record urine output. Acts professionally throughout the procedure in accordance with NMC (2018) 'The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates'.

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 the procedure in accordance with NMC (2018) 'The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates'.

Correct answer: Marking criteria: 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. Recognises the need to be 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: Marking criteria: 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 the Intensive Care Unit (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. Invite Mrs Green back in 2 or 3 months’ time for follow-up support.