NCLEX-style Prioritization & Delegation: cram pack

Which task should the nurse delegate to a nursing assistant for a patient on fall precautions?

1. ATeaching the family how to prevent falls at home
2. BAssessing and recording the patient’s fall risk score each morning
3. CDeciding whether the bed alarm is still needed
4. DHelping the patient to the toilet every 2 hours as planned

Which patient on a renal unit should the nurse see first?

1. AA patient on hemodialysis who missed yesterday’s session and now has muscle weakness and an irregular pulse
2. BA patient asking for advice about a low-phosphate diet
3. CA patient whose arteriovenous fistula has a strong thrill and bruit
4. DA patient on peritoneal dialysis whose drained fluid is clear

Which type of white blood cell is most often raised in viral infections?

1. ALymphocytes
2. BBasophils
3. CNeutrophils
4. DEosinophils

On admission, the medication list from home includes a blood thinner that is not on the new hospital orders. What should the nurse do?

1. AClarify the discrepancy with the prescriber
2. BIgnore it, as the hospital orders replace home medicines
3. CGive the home dose without an order
4. DTell the patient to take their own supply secretly

A healthy patient has a mildly raised CK after running a marathon yesterday, without dark urine or symptoms. What is the most likely explanation?

1. AAn acute myocardial infarction has occurred
2. BThe patient has developed acute pancreatitis
3. CStrenuous exercise raised CK from skeletal muscle
4. DThe patient has developed acute hepatitis

A patient's AST is about twice the ALT, both moderately raised, and the GGT is high. Which cause is most likely?

1. AAlcohol-related liver disease
2. BAcute viral hepatitis A
3. CAcute myocardial infarction
4. DGallstone blocking the bile duct

A patient is receiving enteral feeding through a nasogastric tube. How should they be positioned during feeding?

1. ALying completely flat
2. BWith the head of the bed raised to at least 30 degrees
3. CLying on the left side with the head down to help the feed drain
4. DIn any position, as long as the feed runs slowly

A patient has a single hot, swollen, very painful knee and a fever. Why is urgent joint aspiration important?

1. ATo rule out septic arthritis, which can rapidly destroy the joint
2. BTo prevent osteoporosis
3. CTo measure the patient's cholesterol
4. DTo check for rheumatoid arthritis antibodies in the joint fluid

Why must intravenous potassium chloride never be given as a rapid push or undiluted?

1. AIt works only when given by mouth
2. BIt immediately lowers the blood glucose to dangerous levels
3. CIt turns into solid crystals inside the vein and blocks it
4. DA sudden high potassium level can cause cardiac arrest

Three days after an MI, a patient faints on the commode while straining hard to open the bowels. The heart rate was 42/min at the time. What is the most likely mechanism?

1. AA vagal response to straining
2. BA new pulmonary embolism
3. CAn allergic reaction to the commode
4. DLow blood glucose from fasting

Which group of problems is typical of primary hyperparathyroidism?

1. AHeat intolerance, tremor, weight loss and diarrhoea
2. BHair loss, weight gain and feeling cold
3. CKidney stones, bone pain, abdominal pain and low mood
4. DMuscle cramps, tingling lips and seizures

A nurse teaches a patient with CKD and a high potassium about diet. Which statement shows a need for further teaching?

1. A"I will keep bananas and dried fruit to a minimum."
2. B"I will boil my potatoes and throw away the water."
3. C"I will use a salt substitute instead of ordinary salt."
4. D"I will check food labels for added salt when I go shopping."

After a spinal anaesthetic, which nursing check is particularly important?

1. APeak flow before and after each meal
2. BPupil reaction every five minutes for the next full day
3. CReturn of leg sensation and movement, and passing urine
4. DBlood glucose every 15 minutes overnight

In recovery, an awake and anxious patient cannot lift their head, and their breaths are shallow and weak. What is the most likely cause?

1. AResidual neuromuscular blockade
2. BA simple panic attack
3. CNormal tiredness after surgery
4. DOpioid overdose with pinpoint pupils