1
CST Specialty EXAM (2025) Latest
Questions and Answers| FULLY Updated
A patient with Down syndrome becomes distressed during wound dressing. What’s the most
appropriate first step?
Speak slowly, maintain eye contact, and involve their carer if present. Calming them down
matters more than rushing the dressing.
You're called to assess a toddler with a sudden high-pitched cry and stiff limbs. What should you
suspect?
Think raised intracranial pressure, maybe meningitis. That cry and posturing are classic red
flags—get a doctor urgently.
An elderly patient with Parkinson’s struggles to swallow their meds. What's your priority here?
Switch to crushed or liquid forms if safe, and refer to SALT (Speech and Language
Therapy). Choking risk is serious.
A 24-year-old with sickle cell anaemia reports chest pain and breathlessness. What condition
needs ruling out fast?
Acute chest syndrome—it’s common in sickle cell and can be life-threatening. Needs
oxygen, pain relief, and maybe a chest X-ray.
, 2
A teenager with Type 1 diabetes is confused and sweating. What’s likely going on?
Probably hypoglycaemia. Give fast-acting sugar like juice or glucose gel and recheck their
blood sugar after 10–15 minutes.
\
You're doing a neuro obs check on a post-op spinal patient and their leg strength drops suddenly.
Why act quickly?
Could be spinal cord compression or haematoma—needs urgent review to stop permanent
nerve damage.
A child with autism gets overwhelmed by noise in the waiting area. What's the best nursing
response?
Offer a quiet space or sensory tools. These kids can get overstimulated really fast, and a
meltdown could make care harder.
A frail patient with dementia keeps pulling out their IV. What should you do?
Try distraction or cover the site. Use mitts only as a last resort—restraint should be avoided
where possible.
You're about to give an IM injection to a patient with a BMI over 40. What should you consider?
Use a longer needle and maybe inject in the ventrogluteal site—fat thickness affects drug
absorption.
, 3
Your patient with schizophrenia refuses oral meds and is escalating in aggression. What’s the
safe plan?
Alert mental health team, offer IM as per care plan, and prioritise safety for them and the
team. Don’t go solo.
You're assisting with feeding an older stroke patient with left-sided weakness. What technique
helps?
Sit them upright, feed from their stronger side, and watch for signs of aspiration like
coughing or gurgling voice.
A child on chemotherapy presents with fever and no other symptoms. Why is this a big deal?
They’re likely neutropenic—can’t fight infection well. Even a low-grade fever might be
sepsis. Needs urgent bloods and IV antibiotics.
A young adult with epilepsy has a seizure lasting over 5 minutes. What’s your next action?
That’s status epilepticus. Time it, call for help, and give buccal midazolam or IV lorazepam
as per protocol.
A post-op cardiac surgery patient develops a sudden drop in BP and muffled heart sounds. What
emergency could this be?
Cardiac tamponade—fluid’s squashing the heart. Get help fast and don’t ignore the signs.
, 4
You're looking after a patient with a long history of IVDU (intravenous drug use) and signs of
endocarditis. What observations matter most?
Watch for fever, new murmurs, and signs of emboli (like Janeway lesions). Infection can
damage valves and spread.
A learning-disabled adult refuses personal care but is at risk of skin breakdown. What’s a fair
way forward?
Try to build trust, use simple language, and offer choices. Forcing care rarely helps—consent
and dignity matter.
A COPD patient is on high-flow oxygen and starts getting drowsy. What’s going wrong?
They might be retaining CO2. Switch to controlled oxygen (like Venturi) and get help—it’s a
common error.
You’re checking a pressure ulcer in a diabetic patient and see black necrotic tissue. What’s your
priority?
That’s unstageable—needs urgent tissue viability input. Could become infected or mask
deeper damage.
A confused elderly patient has dry mucosa, high HR, and poor urine output. What's likely the
issue?
Dehydration—probably from poor intake or infection. Needs fluids and maybe bloods to
check U&Es.
CST Specialty EXAM (2025) Latest
Questions and Answers| FULLY Updated
A patient with Down syndrome becomes distressed during wound dressing. What’s the most
appropriate first step?
Speak slowly, maintain eye contact, and involve their carer if present. Calming them down
matters more than rushing the dressing.
You're called to assess a toddler with a sudden high-pitched cry and stiff limbs. What should you
suspect?
Think raised intracranial pressure, maybe meningitis. That cry and posturing are classic red
flags—get a doctor urgently.
An elderly patient with Parkinson’s struggles to swallow their meds. What's your priority here?
Switch to crushed or liquid forms if safe, and refer to SALT (Speech and Language
Therapy). Choking risk is serious.
A 24-year-old with sickle cell anaemia reports chest pain and breathlessness. What condition
needs ruling out fast?
Acute chest syndrome—it’s common in sickle cell and can be life-threatening. Needs
oxygen, pain relief, and maybe a chest X-ray.
, 2
A teenager with Type 1 diabetes is confused and sweating. What’s likely going on?
Probably hypoglycaemia. Give fast-acting sugar like juice or glucose gel and recheck their
blood sugar after 10–15 minutes.
\
You're doing a neuro obs check on a post-op spinal patient and their leg strength drops suddenly.
Why act quickly?
Could be spinal cord compression or haematoma—needs urgent review to stop permanent
nerve damage.
A child with autism gets overwhelmed by noise in the waiting area. What's the best nursing
response?
Offer a quiet space or sensory tools. These kids can get overstimulated really fast, and a
meltdown could make care harder.
A frail patient with dementia keeps pulling out their IV. What should you do?
Try distraction or cover the site. Use mitts only as a last resort—restraint should be avoided
where possible.
You're about to give an IM injection to a patient with a BMI over 40. What should you consider?
Use a longer needle and maybe inject in the ventrogluteal site—fat thickness affects drug
absorption.
, 3
Your patient with schizophrenia refuses oral meds and is escalating in aggression. What’s the
safe plan?
Alert mental health team, offer IM as per care plan, and prioritise safety for them and the
team. Don’t go solo.
You're assisting with feeding an older stroke patient with left-sided weakness. What technique
helps?
Sit them upright, feed from their stronger side, and watch for signs of aspiration like
coughing or gurgling voice.
A child on chemotherapy presents with fever and no other symptoms. Why is this a big deal?
They’re likely neutropenic—can’t fight infection well. Even a low-grade fever might be
sepsis. Needs urgent bloods and IV antibiotics.
A young adult with epilepsy has a seizure lasting over 5 minutes. What’s your next action?
That’s status epilepticus. Time it, call for help, and give buccal midazolam or IV lorazepam
as per protocol.
A post-op cardiac surgery patient develops a sudden drop in BP and muffled heart sounds. What
emergency could this be?
Cardiac tamponade—fluid’s squashing the heart. Get help fast and don’t ignore the signs.
, 4
You're looking after a patient with a long history of IVDU (intravenous drug use) and signs of
endocarditis. What observations matter most?
Watch for fever, new murmurs, and signs of emboli (like Janeway lesions). Infection can
damage valves and spread.
A learning-disabled adult refuses personal care but is at risk of skin breakdown. What’s a fair
way forward?
Try to build trust, use simple language, and offer choices. Forcing care rarely helps—consent
and dignity matter.
A COPD patient is on high-flow oxygen and starts getting drowsy. What’s going wrong?
They might be retaining CO2. Switch to controlled oxygen (like Venturi) and get help—it’s a
common error.
You’re checking a pressure ulcer in a diabetic patient and see black necrotic tissue. What’s your
priority?
That’s unstageable—needs urgent tissue viability input. Could become infected or mask
deeper damage.
A confused elderly patient has dry mucosa, high HR, and poor urine output. What's likely the
issue?
Dehydration—probably from poor intake or infection. Needs fluids and maybe bloods to
check U&Es.
