NCLEX-style Prioritization & Delegation: cram pack

A nurse takes a telephone order from a provider. What must the nurse do?

1. ARemember the order and write it in the chart at the end of the shift
2. BAsk the ward clerk to take the order on the nurse’s behalf instead
3. CWrite the order down and read it back to the provider to confirm it
4. DCarry out the order first and ask the provider to confirm it later

After the RN taught a patient to inject insulin, an LPN/LVN reports that the patient still cannot draw up the dose correctly. What should happen next?

1. AThe LPN/LVN writes a new teaching plan and evaluates it at the end of the shift
2. BThe nursing assistant shows the patient again at lunch
3. CThe patient is discharged with a leaflet to read at home
4. DThe RN reassesses the patient’s learning needs and adjusts the teaching

A patient receiving continuous nasogastric feeding has pulled the tube partly out. What should the nurse do first?

1. AIncrease the feed rate to make up for the lost time
2. BTape the tube in its new position and continue
3. CPush the tube back in and restart the feed
4. DStop the feeding until the tube position is checked

Which patient most needs fall precautions?

1. AAn alert patient on bed rest who follows instructions
2. BA patient awaiting discharge who walks independently
3. CAn older patient, newly confused, on a sedative, with an unsteady gait
4. DA young adult with a broken finger who walks steadily and safely unaided

How does the nurse start a 24-hour urine collection at 08:00?

1. ASave three samples spread across the day and discard all of the urine passed at night
2. BHave the patient void and discard that urine, then save all urine until 08:00 the next day
3. CSave the 08:00 urine as the first sample, then collect until 08:00 the next day
4. DCollect only the first urine passed on waking, and repeat this the next morning

After a crush injury, a patient's urine dipstick is strongly positive for blood, but microscopy shows almost no red cells. CK is very high. What best explains this?

1. AThe sample was contaminated with menstrual blood
2. BMyoglobin from damaged muscle is in the urine
3. CBleeding is coming from the bladder lining
4. DA kidney stone is scraping the ureter lining

How does CPAP help a patient with obstructive sleep apnoea?

1. AIt removes excess carbon dioxide from the lungs by gentle suction
2. BIt keeps the upper airway open during sleep with continuous air pressure
3. CIt strengthens the breathing muscles during the day
4. DIt delivers bronchodilator drugs deep into the lungs overnight

A nurse teaches a patient with reflux disease. Which statement shows a need for further teaching?

1. A"I will try to lose some weight over the next months."
2. B"A big meal just before bed is fine if I take my tablet."
3. C"I will cut down on alcohol."
4. D"I will raise the head of my bed with blocks."

After thrombolysis for a myocardial infarction, which complication is the nurse most concerned to detect?

1. AA skin rash appearing at the sites of the ECG electrodes
2. BConstipation from bed rest
3. CA high blood glucose caused by the thrombolytic drug itself
4. DBleeding, including a sudden change in neurological status

A patient with asthma has a history of wheeze after taking aspirin. Ibuprofen is prescribed for postoperative pain. What should the nurse do?

1. AGive it, because ibuprofen is not related to aspirin
2. BGive it only if the pain score is above 8/10
3. CWithhold it and ask for an alternative
4. DGive it with the reliever inhaler at the same time

A patient takes an SGLT2 inhibitor. Which sick-day advice is correct?

1. ADouble the dose during illness to control the glucose
2. BStop drinking fluids while taking the drug
3. CKeep taking it as normal, whatever the illness
4. DPause the drug during illness with vomiting or poor intake

Two days after an ileal conduit was formed, the stoma is dark purple and dry. What should the nurse do?

1. ARecord it as normal for a new stoma
2. BApply a warm compress to improve the colour of the stoma
3. CChange the bag and check again next week
4. DReport it urgently, because the stoma may be ischaemic

What is achalasia?

1. AA tear at the junction of the oesophagus and the stomach
2. BFailure of the lower oesophageal sphincter to relax on swallowing
3. CInflammation of the oesophagus caused by a fungal infection
4. DWeakness of the lower oesophageal sphincter that allows reflux

A nurse teaches a patient after a colonoscopy with polyp removal. Which statement shows a need for further teaching?

1. A"I should report a fever or a swollen, painful abdomen."
2. B"Some wind and bloating today is expected."
3. C"Severe abdominal pain is normal for a week afterwards."
4. D"I'll report heavy bleeding from my bottom."