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

Mock APIE: Grief and bereavement - Scenario The mock APIE below is made up of four stations: assessment, planning, implementation and evaluation. Each station will last up to 20 minutes and is scenario-based. The instructions and available resources are provided for each station, along with the specific timing. Scenario Frankie Kapalis has a mild learning disability and Williams syndrome. However, Frankie can communicate verbally and is capable of independent self-care. They have lived in a supported living facility for the past 10 years. Two months ago, another resident at the complex, who Frankie was very friendly with, passed away suddenly. Since the loss of their friend, Frankie has become less talkative and increasingly reluctant to go to work or attend social group outings. Frankie has a loss of appetite and is no longer eating full meals. Frankie is becoming more resistant to eating meals, even with support from friends. You will be asked to complete the following activities to provide high-quality, individualised nursing care for the patient, providing an assessment of needs that is based on the recovery model of care. All four of the stages in the nursing process will be continuous and will link with each other. Station: Assessment – 20 minutes. You will collect, organise and document information about the patient. Resources: Assessment overview and documentation (pages 10–14); A Glasgow depression scale completed by the patient (pages 15–19); A copy of the Hospital Communication Book, for reference (pages 20–43). Station: Planning – 14 minutes. You will complete the planning template, choosing two aspects of the patient's care needs and establishing how they will be met. Resources: A completed nursing care plan for two nursing care problems or needs (pages 44–47). Station: Implementation – 15 minutes. You will administer and document medications while continuously assessing the individual's current health status. Resources: An overview and a medication administration record (MAR) (pages 48–51). Station: Evaluation – 8 minutes. You will document the care that has been provided so that you can do a verbal handover to the nurse on the next shift (the examiner). Resources: Documents from the previous three stations; A blank situation, background, assessment and recommendation (SBAR) tool (pages 52–53). You are a registered nurse for people who have learning disability working in a purpose-built residential facility supporting Frankie Kapalis. Frankie is a resident with a learning disability. Frankie may be experiencing issues of bereavement following the loss of their friend. Please conduct a holistic assessment of the patient's physical, psychosocial, spiritual and sexual care needs. Please proceed with your nursing assessment by calculating a pre-completed Glasgow depression scale score. The score must be calculated within this station. Please discuss the clinical response and outcome of the Glasgow depression scale with Frankie. Complete your assessment using the headings in the table below. You may focus on the following TWO care needs to help you to develop a care and support plan in the planning station. • Deteriorating mental and physical health • Social needs This document must be completed using a GREEN PEN. Assume that it is TODAY and that it is 10:00 hours.

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You are working on the surgical admissions unit. You are caring for Catherine Higgins, who has been diagnosed with obstruction of the bowel, and the doctor has requested the insertion of a urinary catheter for fluid monitoring. Please insert the urinary catheter according to current evidence-based practice. All identification checks have been completed and the patient has no known allergies. The trolley has been cleaned. The patient is lying in bed, with their lower clothing removed, is covered with a towel and has an absorbent pad underneath them. All the equipment you need is provided. You are not required to document anything during this skills station. You have 8 minutes to complete this station.

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You are working on a post-operative surgical ward. You are caring for Kendi Abara, who has undergone a right hemicolectomy and colostomy formation. They are 3 days post surgery, the one-piece stoma bag needs to be replaced, and Kendi is currently not well enough to do this themselves. Please change the patient's stoma bag according to current evidence-based practice. All identification checks have been completed, and the patient has no known allergies. The trolley has already been cleaned prior to the procedure. Please change the patient's stoma bag and speak to your patient throughout the procedure. All the equipment you need is provided. You are not required to document anything during this skill station, but if necessary, verbalise to the examiner what would be documented or reported. You have 8 minutes to complete this station. Assume that it is TODAY and that it is 12:00 hours.

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Scenario: You are just about to commence the lunchtime drug round. You enter the clinical room and one of your nursing colleagues is in the room already. You witness the nurse take a 30 milligram codeine phosphate tablet from the drug cupboard. She puts it in her mouth and swallows it in front of you. You ask if she is okay, and she tells you that she needs the tablet for a headache. As far as you are aware, this is an isolated incident. Using your knowledge of NMC (2018) 'The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates', consider the professional, ethical and legal implications of this situation. Please summarise the actions you would take in a number of bullet points.

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Read the scenario and the summary of the research below. Please identify the main points from the summary and apply the findings to the scenario below. Scenario: You have been working on an Intensive Care Unit (ICU) for the past 6 months. Most of your patients are given medication to induce a coma while they receive care and treatment. As patients improve and are weaned off the sedation, you notice that it is common for patients to report that they have not slept for the whole time they have been on the unit. The patient you are looking after today, Mrs Green, reports this same lack of sleep. She asks if is this common and, if so, why it might be. Article summary: A systematic review in a well-regarded peer-reviewed journal investigated the sleep disturbances in patients in intensive care units. The review found that: • Study A, a large-scale study, showed that 60% of patients discharged from ICU reported sleep disorders and deprivations. • Study B, a smaller study, found similar results, with 51% of patients experiencing dreams and nightmares, and 14% reporting nightmares negatively impacting their quality of life 6 months after discharge from ICU. The study recommended that patients return for a follow-up support appointment 2 to 3 months after leaving ICU. • Study C, a quantitative study, concluded that the inability to obtain physiological sleep depends on the patient's illness, previous sleep experience and the varying severity of their illness. • Patients in Study C reported a number of sleep-disturbing factors impacting their sleep, including: noise, light, pain, anxiety, nursing interventions, diagnostic tests, medications and non-invasive ventilation. The review concluded that sleep disorders in ICU were common and that there were multiple influencing factors causing sleep deprivation. What is the relevance of the findings of this research for Mrs Green, and what advice would you give her? Give your responses here as bullet points.

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