NCLEX-style Prioritization & Delegation: cram pack

Which two patients can most safely share a room?

1. AA patient with MRSA in a wound and a patient after surgery
2. BA patient with influenza and a patient with COPD
3. CTwo patients who both have C. difficile infection
4. DA patient with chickenpox and a patient on chemotherapy

Four stable patients need routine morning care. To reduce the spread of infection, which patient should the nurse visit first?

1. AA patient with an MRSA wound infection
2. BA patient with influenza on droplet precautions
3. CA patient with C. difficile diarrhea
4. DA patient with neutropenia after chemotherapy

What should a nurse do after an accidental splash of a patient’s blood into the eyes?

1. AApply antibiotic eye drops and tell no one
2. BRinse the eyes at once with plenty of water or saline, then report
3. CFinish the procedure, then report it the next day
4. DRub the eyes gently with a clean, dry tissue to remove the blood first

A patient with severe immunosuppression after a stem cell transplant is in a protective environment. Which item should not be brought into the room?

1. AA family photo in a frame that has been wiped clean
2. BFresh flowers or potted plants
3. CA clean, disinfected tablet computer
4. DThe patient’s own clean clothes

Which finding during a transfusion suggests transfusion-associated circulatory overload (TACO)?

1. ABack pain with dark red urine output
2. BCrackles, hypertension and a raised BNP
3. CA low temperature and slow heart rate
4. DHives and itching without other signs

A patient with long-standing rheumatoid arthritis has a hemoglobin of 10.5 g/dL (105 g/L), a low serum iron, a low total iron-binding capacity (TIBC) and a high-normal ferritin. Which condition fits best?

1. AAcute blood loss anemia
2. BAnemia of chronic disease (inflammation)
3. CVitamin B₁₂ deficiency anemia
4. DIron-deficiency anemia

A patient has colicky abdominal pain, a swollen abdomen, vomiting and has not passed stool or wind for two days. What is the likely problem?

1. AGastroenteritis
2. BBowel obstruction
3. CIrritable bowel syndrome
4. DAppendicitis without complications

A patient going home after chemotherapy is taught about infection. Which statement shows a need for further teaching?

1. A"I will check my temperature if I feel unwell or shivery at home."
2. B"I will phone the helpline if I have a fever or shivering."
3. C"I will wash my hands well before eating and after using the toilet."
4. D"If I get a temperature, I'll take paracetamol and wait until my next clinic."

A 34-year-old has hypertension that is hard to control and a low serum potassium without taking diuretics. Which cause should be considered?

1. AEssential hypertension of ageing
2. BIron-deficiency anaemia
3. CPrimary hyperaldosteronism
4. DHypothyroidism

After hip surgery, a patient suddenly becomes breathless and anxious with a heart rate of 124/min, SpO₂ 86% on air and sharp pain on breathing. The chest sounds clear. What should the nurse do first?

1. AGive oxygen, sit them up, call for urgent review and stay
2. BGive a sedative for the anxiety and recheck in an hour
3. CWalk the patient round the ward to improve breathing
4. DLie the patient flat and raise both legs on pillows

What is the dexamethasone suppression test used for?

1. ATo measure kidney function
2. BTo diagnose diabetes insipidus
3. CTo check thyroid function
4. DTo help diagnose Cushing's syndrome

A patient with an acute stroke has a glucose of 15 mmol/L (270 mg/dL). They do not have known diabetes. What is appropriate?

1. AStop all IV fluids to lower the glucose
2. BGive glucose gel to stabilise the level
3. CIgnore it, because stress always raises glucose
4. DReport it and monitor glucose, as it can worsen outcome

Why are carbohydrate drinks often given before surgery in enhanced recovery programmes?

1. ATo make the bowels open before the operation
2. BTo replace the need for any IV fluids afterwards
3. CTo raise the blood pressure during the anaesthetic
4. DTo reduce insulin resistance and improve recovery

A patient who takes NSAIDs suddenly develops severe epigastric pain, a rigid abdomen and shoulder-tip pain. Which finding would most support the likely diagnosis?

1. AA raised serum lipase three times the upper limit
2. BFree air under the diaphragm on an erect chest X-ray
3. CFluid levels in the bladder on an ultrasound scan
4. DTall, peaked T waves on a 12-lead ECG