NCLEX-style Prioritization & Delegation: cram pack

Before giving a medication to a child, which check is especially important?

1. AThat the parent agrees with the time it is given
2. BThat the medicine cup is the child’s favorite color
3. CThat the dose is correct for the child’s weight
4. DThat the child likes the taste of the drug

During a power cut, which patient is the nurse’s first priority?

1. AA patient whose bed will not raise electrically
2. BA patient watching television when it switched off
3. CA patient whose call light is not working
4. DA patient who depends on a ventilator

A nurse wants to set up a sterile field in the morning for a procedure that will take place after lunch. What is correct?

1. ASet it up in the morning and cover it with a clean towel until the procedure starts
2. BSet it up in the morning and ask a colleague to check it once
3. CSet it up in the morning and leave it uncovered in an empty room
4. DSet it up just before the procedure, because a waiting field may become contaminated

A night nurse suggests restraining a calm but wandering patient “so we can manage with fewer staff tonight”. Which response is correct?

1. ARestraint is never for staff convenience; use rounding or a sitter
2. BRestraints are acceptable if removed in the morning
3. CRestraints are acceptable if the family agrees to them in writing first
4. DRestraints are acceptable at night when staffing is low

After pituitary surgery, a patient passes about 400 mL of pale urine per hour with a specific gravity of 1.002, and the sodium has risen to 149 mEq/L. Which condition is most likely?

1. ADiabetes insipidus
2. BAcute kidney injury with oliguria
3. CSIADH
4. DHyperglycemia with ketoacidosis

A patient with ongoing hemolytic anemia has an HbA1c of 4.6%, but home glucose readings are often 180–220 mg/dL (10–12 mmol/L). What best explains the gap?

1. AThe patient has true, well-controlled diabetes
2. BShort red cell life span lowers the HbA1c falsely
3. CHemolysis makes the HbA1c test read too high
4. DThe home glucose meter is reading falsely high

A nurse suspects that an older patient is being financially abused by a relative. What should the nurse do?

1. AKeep it secret because it is a family matter
2. BWait until the patient has been discharged
3. CConfront the relative directly at the bedside about it
4. DRaise the concern through the local safeguarding (adult protection) procedure

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 measure the patient's cholesterol
3. CTo check for rheumatoid arthritis antibodies in the joint fluid
4. DTo prevent osteoporosis

What is the ejection fraction?

1. AThe pressure in the left ventricle at the end of diastolic filling
2. BThe percentage of ventricular blood ejected with each beat
3. CThe volume of blood the heart pumps out every minute
4. DThe volume of blood pumped out with each heartbeat

After a car crash, a patient is severely breathless with absent breath sounds on the right, a deviated trachea, distended neck veins and BP 76/40 mmHg. What is the immediate management?

1. ALying the patient flat with the legs raised
2. BA chest X-ray to confirm the diagnosis before any treatment
3. CInsertion of a urinary catheter to monitor output
4. DUrgent needle or finger decompression of the right chest

A patient has just started haemodialysis. What usually happens to their protein needs?

1. AThey fall to almost zero to rest the kidneys
2. BProtein must be replaced only by IV infusion
3. CThey stay exactly the same as they were before dialysis
4. DThey increase, because dialysis removes amino acids

On the first day after a kidney transplant, urine output suddenly falls from 200 mL/h to 10 mL/h. What should the nurse check first?

1. AWhether the patient has eaten
2. BThe patient's blood glucose level
3. CThat the catheter is not blocked or kinked
4. DThe patient's temperature and pulse

Which electrolyte problem can occur in severe acute pancreatitis?

1. AHyperkalaemia
2. BHypocalcaemia
3. CHypercalcaemia
4. DHypernatraemia

During a nasogastric feed, a patient starts coughing and SpO₂ falls from 96% to 89%. What should the nurse do first?

1. AGive a drink of water to clear the throat
2. BIncrease the feed rate to finish it sooner
3. CLay the patient flat to help them rest
4. DStop the feed and assess the airway and breathing