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NMC CBT·ModuleASSESSMENT-CARE-PLANNING

Module 3: Assessment and Care Planning

Module 3 assesses knowledge of nursing assessment and care planning frameworks required for UK registered nurse practice. Topics include the Activities of Daily Living model (Roper–Logan–Tierney), holistic assessment, admission assessment, risk assessment tools, vital signs measurement, pain assessment tools, neurological assessment, fluid balance monitoring, the nursing care plan and SMART goals, evidence-based practice, discharge planning, and management of long-term conditions including diabetes, COPD, heart failure, and chronic kidney disease.

Questions
711
Units
4
Topics
16

What’s in it.

4 units

Sample questions

3 of many

A few questions from this module, with the answer and a full explanation. The complete bank is available when you start practising.

  1. A patient with a brain injury lacks capacity for complex treatment decisions but retains capacity for decisions about their daily care routine. The MDT wishes to implement a 24-hour nursing observation plan without discussing it with the patient. Which of the following BEST describes the correct approach?

    • The patient should be consulted about the observation plan only if they have a registered LPA for health and welfare in place to represent their interests during the discussion
    • The patient's incapacity for complex decisions means all decisions — including daily routine matters — automatically fall to the MDT under best-interests principles without exception
    • The patient cannot be involved in any care planning decisions once a brain injury has been formally documented in the clinical record, as documentation of the injury establishes incapacity
    • Capacity is decision-specific; the patient retains capacity for decisions about their daily routine, which may include aspects of the observation plan; these should be discussed with the patient, and only the aspects of the plan for which the patient lacks capacity should be decided through a best-interests process
      Correct answer
    Explanation

    This question tests a nuanced but fundamental MCA principle: capacity is decision-specific. A patient who lacks capacity for complex medical decisions (such as surgical treatment choices) may retain full capacity for simpler decisions about their daily routine (such as preferred meal times, washing preferences, or aspects of their care schedule). The 24-hour observation plan may include elements that fall within the patient's retained decision-making capacity. These should be discussed with and agreed by the patient. Only those aspects of the plan for which the patient genuinely lacks capacity should be decided through a formal best-interests process. Treating all decisions as requiring best-interests processing because of incapacity in one domain is a breach of the decision-specific nature of capacity under MCA 2005.

  2. A colleague argues that all COPD patients should receive controlled low-flow oxygen because 'you can never be too careful with COPD.' How should the nurse respond based on current BTS guidelines?

    • Only COPD patients with confirmed or suspected type 2 respiratory failure require the 88–92% target; most COPD patients should have the standard 94–98% target to avoid under-oxygenation
      Correct answer
    • The colleague is correct; all COPD patients must have a target SpO2 of 88–92% regardless of their CO2 retention history
    • The 94–98% target only applies to non-respiratory conditions; COPD patients all need the 88–92% target
    • Oxygen therapy should always be withheld from COPD patients until written consent is obtained
    Explanation

    A common and potentially harmful misconception is that all COPD patients need restricted oxygen. BTS Emergency Oxygen guidelines clearly state that the 88–92% target applies only to those at risk of hypercapnic respiratory failure (known type 2 failure or risk factors). Most COPD patients do not have chronic hypercapnia and should have the standard 94–98% target. Restricting oxygen unnecessarily in a COPD patient without type 2 failure risks significant under-treatment of hypoxaemia. Oxygen prescriptions in hospitals should specify the target saturation to guide nursing administration.

  3. Which stage of the nursing process involves systematically collecting data about the patient?

    • Planning
    • Implementation
    • Documentation
    • Assessment
      Correct answer
    Explanation

    Assessment is the first stage of the nursing process. It involves the systematic collection of subjective data (what the patient reports) and objective data (what the nurse observes and measures). This data forms the foundation for identifying patient problems and writing goals in the subsequent Planning stage.

Frequently asked questions

3 questions
What nursing assessment frameworks are tested in the NMC CBT?

The NMC CBT tests the Activities of Daily Living model (Roper–Logan–Tierney), holistic assessment approaches, admission assessment and baseline observations, and risk assessment tools for falls, pressure ulcers, and VTE.

Are long-term conditions included in the NMC CBT assessment module?

Yes. Module 3 includes questions on managing long-term conditions in nursing practice, including diabetes mellitus, COPD, heart failure, and chronic kidney disease, as well as self-management support and health coaching principles.

What is evidence-based practice in the NMC CBT context?

Evidence-based practice refers to integrating the best available research evidence with clinical expertise and patient preferences. The NMC CBT tests candidates' ability to apply clinical guidelines and research to care planning decisions.