NCLEX-style Prioritization & Delegation: cram pack

A nurse needs to give report on a patient to a colleague. Which information is the most important to include?

1. AThe patient’s favorite television programs and hobbies
2. BDetails of the nurse’s own break times that shift
3. CPersonal opinions about the patient’s family members and their visiting habits
4. DThe patient’s current condition, recent changes and pending tasks

Four laboratory results come back at once. Which one should the nurse report first?

1. APotassium 3.4 mEq/L in a patient on a diuretic
2. BCreatinine 1.3 mg/dL in an older adult, unchanged from last week
3. CGlucose 180 mg/dL after a meal in a patient with diabetes
4. DHemoglobin 6.5 g/dL (65 g/L) in a patient with a GI bleed

Which IV fluid can be given with packed red blood cells in the same line?

1. A5% dextrose in water
2. BLactated Ringer’s (Hartmann’s) solution
3. C5% dextrose in 0.45% sodium chloride
4. D0.9% sodium chloride

During a procedure, a nurse sees that the team is about to start without a time-out. What should the nurse do?

1. AReport it to the manager at the end of the week
2. BWait and raise the issue after the procedure is finished
3. CSay nothing, because the surgeon is responsible for the procedure
4. DSpeak up clearly and stop the start until the time-out is done

In countries that screen all pregnant women (such as the US), a vaginal-rectal swab is taken at about 36–37 weeks. Which organism is it screening for?

1. ACandida albicans
2. BHepatitis B virus
3. CStaphylococcus aureus
4. DGroup B Streptococcus

A patient with heart failure takes lisinopril, spironolactone and a potassium supplement. Today the potassium is 6.0 mEq/L. What is the most likely explanation?

1. APotassium supplements have no effect on the serum level
2. BSpironolactone causes potassium loss
3. CLisinopril lowers potassium
4. DSeveral medicines that raise potassium are being taken together

A patient's seizure has lasted more than five minutes. What does this mean?

1. APlace something in the mouth to prevent tongue biting
2. BRestrain the limbs to stop the movements
3. CIt is normal and needs no treatment
4. DIt should be treated as status epilepticus and emergency medication given

Why can pulse oximetry be misleading in carbon monoxide poisoning?

1. AStandard oximeters cannot tell carboxyhaemoglobin from oxyhaemoglobin
2. BCarbon monoxide makes the oximeter read zero even in a well patient
3. CCarbon monoxide only affects the heart rate reading
4. DThe oximeter overheats in smoke-exposed patients

Which position is usually best for the legs of a patient with chronic venous insufficiency and ankle swelling?

1. ARaised above the level of the heart when resting
2. BCrossed at the knees while sitting
3. CHanging down over the side of the bed
4. DKept still in a standing position for long periods

Which instruction from the registered nurse to a healthcare assistant (unlicensed assistive personnel) caring for a patient with COPD is most appropriate?

1. A"Tell me straight away if his SpO₂ is under 88% or he is more breathless."
2. B"Turn his oxygen up to whatever he needs if he looks short of breath."
3. C"Teach him how to use his new inhaler this afternoon after his rest."
4. D"Listen to his chest after lunch and let me know what you can hear."

How does bladder training help urge incontinence?

1. AThe patient drinks as little as possible
2. BThe patient goes to the toilet every 15 minutes
3. CA catheter is used every night
4. DThe time between voids is slowly increased

A 74-year-old falls forward and hits their chin. Their arms are much weaker than their legs, and they have burning pain in the hands. Which injury is most likely?

1. ABrown-Séquard syndrome
2. BCentral cord syndrome
3. CCauda equina syndrome
4. DA complete lumbar cord injury

Which drug class is used to reduce the risk of a first variceal bleed in cirrhosis?

1. AThiazide diuretics
2. BProton pump inhibitors
3. CCalcium supplements
4. DNon-selective beta-blockers

Two days after starting chemotherapy for a high-grade lymphoma, a patient's urine output falls; potassium is 6.4 mmol/L, phosphate high and calcium low. What should the nurse suspect and do?

1. ATumour lysis syndrome: escalate, start cardiac monitoring and expect IV fluids
2. BSimple dehydration: encourage oral fluids and recheck bloods next week
3. CExpected chemotherapy side effects: no action needed until the next cycle
4. DAn allergic reaction: give an antihistamine and continue as normal