NCLEX-style Prioritization & Delegation: cram pack

Which scheduled medication is the most time-critical?

1. ARapid-acting insulin due with a breakfast tray that has arrived
2. BA daily multivitamin tablet due at 08:00
3. CA daily stool softener due with breakfast
4. DA daily cholesterol-lowering statin tablet due with breakfast at 08:00

A patient is admitted with suspected meningococcal meningitis. Which precautions are needed until treatment has been given for long enough?

1. AStandard precautions only
2. BDroplet precautions
3. CContact precautions only
4. DAirborne precautions

An alcohol-based skin prep has been used before surgery with electrosurgery. What must happen before the drapes are placed?

1. AThe prep must be fully dry and any pooled liquid removed
2. BThe prep must be wiped off with saline
3. CThe prep must be warmed with a hair dryer
4. DThe prep must be covered with the drapes while it is still wet

In START triage at a mass-casualty incident, a casualty cannot walk, breathes 20 times a minute, has a radial pulse and follows simple commands. Which category applies?

1. AGreen (minor)
2. BYellow (delayed)
3. CBlack (expectant or dead)
4. DRed (immediate)

On the first day after major surgery, a patient's white cell count is 12.5 × 10³/µL, with no fever or wound signs. What is the best interpretation?

1. AA laboratory error, since surgery lowers white cells
2. BA sign of leukemia that needs bone marrow testing
3. CA common stress response to surgery that is monitored
4. DDefinite wound infection that needs antibiotics now

A patient on a thiazide diuretic has a sodium of 129 mEq/L, a potassium of 3.2 mEq/L and feels weak. Which explanation fits best?

1. AThe patient is overhydrated from IV fluids only
2. BThe results are typical of kidney failure
3. CThe patient has primary hyperaldosteronism with high sodium
4. DThe diuretic is causing sodium and potassium loss

A dying patient can no longer drink and has a dry mouth. What is the most appropriate nursing care?

1. ALeaving the mouth alone to avoid disturbing them
2. BInserting a nasogastric tube for fluids
3. CFrequent mouth care that keeps the lips and mouth moist
4. DStarting a fast intravenous infusion to correct the dryness

After a head injury, a patient passes very large volumes of dilute urine and the serum sodium is rising. What is most likely?

1. ADiabetes mellitus
2. BSyndrome of inappropriate ADH secretion
3. CDiabetes insipidus
4. DAcute kidney injury

Which advice is most helpful for a patient with Raynaud's phenomenon?

1. ARub the fingers hard with snow during an attack
2. BTake a decongestant tablet before going outdoors
3. CKeep the whole body warm, wear gloves and stop smoking
4. DSoak the hands in cold water to toughen the vessels

A patient with an acute COPD exacerbation who retains CO₂ is prescribed nebulised bronchodilators. How should the nebuliser usually be driven?

1. AWith compressed air, plus controlled oxygen by nasal cannula
2. BWith oxygen at 15 L/min for as long as possible
3. CWith oxygen at 6–8 L/min and no saturation monitoring
4. DWith no gas flow, by asking the patient to breathe deeply

A patient has hypertension that is hard to control and a persistently low potassium, without taking diuretics. Which condition should be considered?

1. ACranial diabetes insipidus
2. BPrimary adrenal insufficiency (Addison's)
3. CPrimary hyperaldosteronism (Conn's)
4. DPrimary hypothyroidism

An older man has not passed urine for 10 hours, has lower abdominal pain and a bladder scan of 1100 mL. Creatinine has risen. What is the most likely cause and action?

1. ADehydration; give a fluid bolus and recheck the creatinine tomorrow
2. BDiabetes insipidus; give desmopressin and restrict fluids
3. CUrinary retention; catheterise as prescribed and watch for a large diuresis
4. DContrast nephropathy; arrange emergency haemodialysis today

Which monitoring is especially important for a patient receiving parenteral nutrition?

1. ABlood glucose and signs of line infection
2. BPupil size and limb strength
3. CPeak flow and visual acuity
4. DBowel sounds and stool colour only

Which preoperative blood result should the nurse report to the team before elective surgery?

1. ASodium 139 mmol/L
2. BFasting glucose 5.4 mmol/L (97 mg/dL)
3. CPotassium 2.9 mmol/L
4. DHaemoglobin 138 g/L (13.8 g/dL) in a man