NSB236 Week 1 - Recognising the
Deteriorating Patient Exam Q&A 100%
Solved | Verified and Approved
Why is recognising the deteriorating patient important? - ✔✔Failure to
rescue/recognise clinical deterioration is associated with increased patient
mortality
- Clinical staff frequently lack the clinical skills to identify and interpret signs
and symptoms of clinical deterioration
- Poor communication
- Introduction of modified early warning scores (MEWS) track and trigger -
MET and RRS
What are the most common causes for a MET call? - ✔✔Hypoxia
Hypotension
ALOC
Tachycardia
1
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
,Tachypnoea
What are the most Commun underlying causes medical emergency calls
are attributed to? - ✔✔Sepsis
Cardiogenic shock
Pulmonary shock
Arrrythmia
What is important for recognising deterioration? - ✔✔Ability to critically
evaluate assessment findings in the context of the patients primary
condition and co-morbid condition
Understanding of vital signs is paramount
- Normal ranges for vital signs have not been validated
- Consider what is normal in context
What are signs suggestive of sepsis? - ✔✔Temperature >38.3 or <36
Respiratory rate >20
Heart rate >90
2
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
,ALOC or confusion
Hyperglycaemia >7.7
Oliguria (Less than 0.5ml/kg/hr)
What should be assessed with blood pressure? - ✔✔- BP or MAP is
effected by cardiac output and systemic vascular resistance
- Clinical hypotension considered to be 20% decreased in the patients
normal blood pressure or 30mmHg reduction in systolic blood pressure
- Systolic blood pressure less than 100 are difficult to accurately measure
both manually and via electronic devices
- MAP is the perfusion pressure within the arteries during one cardiac cycle
- provides a better indicator of perfusion to organs
— MAP = SBP + (2xDBP)/3
What are the properties of haemodynamic perfusion? - ✔✔Four
cardiovascular properties are necessary to maintain adequate tissue
perfusion for cellular metabolism
- Sufficient CO
- Uncompromised vascular tone
3
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
, - Sufficient blood volume and blood pressure
- Tissues are able to utilise oxygen
What is pulse pressure? - ✔✔The difference between SBP and DBP
- PP = SBP-DBP.
- Conceptually proportional to SV
- Low pulse pressure - insufficient preload, heart failure, shock
- Wide pulse pressure - atherosclerosis, hyperthyroidism, raised ICP
Positive Portsmouth sign
- Heart rate should not go above systolic BP (shock state)
What are the haemodynamic aspects of heart rate? - ✔✔Increased great
rate - reduction in time to allow for ventricular filling
Increased heart rate increased myocardial oxygen demand
Heart rates that exceed blood pressure
4
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
Deteriorating Patient Exam Q&A 100%
Solved | Verified and Approved
Why is recognising the deteriorating patient important? - ✔✔Failure to
rescue/recognise clinical deterioration is associated with increased patient
mortality
- Clinical staff frequently lack the clinical skills to identify and interpret signs
and symptoms of clinical deterioration
- Poor communication
- Introduction of modified early warning scores (MEWS) track and trigger -
MET and RRS
What are the most common causes for a MET call? - ✔✔Hypoxia
Hypotension
ALOC
Tachycardia
1
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
,Tachypnoea
What are the most Commun underlying causes medical emergency calls
are attributed to? - ✔✔Sepsis
Cardiogenic shock
Pulmonary shock
Arrrythmia
What is important for recognising deterioration? - ✔✔Ability to critically
evaluate assessment findings in the context of the patients primary
condition and co-morbid condition
Understanding of vital signs is paramount
- Normal ranges for vital signs have not been validated
- Consider what is normal in context
What are signs suggestive of sepsis? - ✔✔Temperature >38.3 or <36
Respiratory rate >20
Heart rate >90
2
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
,ALOC or confusion
Hyperglycaemia >7.7
Oliguria (Less than 0.5ml/kg/hr)
What should be assessed with blood pressure? - ✔✔- BP or MAP is
effected by cardiac output and systemic vascular resistance
- Clinical hypotension considered to be 20% decreased in the patients
normal blood pressure or 30mmHg reduction in systolic blood pressure
- Systolic blood pressure less than 100 are difficult to accurately measure
both manually and via electronic devices
- MAP is the perfusion pressure within the arteries during one cardiac cycle
- provides a better indicator of perfusion to organs
— MAP = SBP + (2xDBP)/3
What are the properties of haemodynamic perfusion? - ✔✔Four
cardiovascular properties are necessary to maintain adequate tissue
perfusion for cellular metabolism
- Sufficient CO
- Uncompromised vascular tone
3
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
, - Sufficient blood volume and blood pressure
- Tissues are able to utilise oxygen
What is pulse pressure? - ✔✔The difference between SBP and DBP
- PP = SBP-DBP.
- Conceptually proportional to SV
- Low pulse pressure - insufficient preload, heart failure, shock
- Wide pulse pressure - atherosclerosis, hyperthyroidism, raised ICP
Positive Portsmouth sign
- Heart rate should not go above systolic BP (shock state)
What are the haemodynamic aspects of heart rate? - ✔✔Increased great
rate - reduction in time to allow for ventricular filling
Increased heart rate increased myocardial oxygen demand
Heart rates that exceed blood pressure
4
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
