NCLEX-style Prioritization & Delegation: cram pack

A patient with asthma uses a peak flow meter. A reading below 50% of personal best is in the red zone. Which statement shows correct understanding?

1. A“I will use my reliever inhaler and get emergency help straight away.”
2. B“I will go for a short run to open up my lungs.”
3. C“I will wait until tomorrow morning to see if the reading gets better on its own.”
4. D“I will stop all my inhalers until the reading is back up.”

A provider asks a nurse to perform a procedure that is outside the nurse’s scope of practice. What should the nurse do?

1. ADecline, explain why and suggest who can safely do it
2. BAsk a nursing assistant to do it instead
3. CDo it just this once and promise the provider not to do it again
4. DDo it, because the provider gave the instruction

When should a nurse use an extinguisher on a fire?

1. AAlways, even before the alarm has been raised, to save time
2. BWhenever there is smoke, even if the exit is blocked
3. COnly if the fire is small, the alarm is raised and the exit is clear
4. DNever; only firefighters may use fire extinguishers

In US nursing practice, which task should the RN not assign to an LPN/LVN?

1. AGiving scheduled oral antibiotics to a stable patient
2. BReinforcing hand hygiene teaching that the RN has already given
3. CA dressing change on a healing surgical wound that has no signs of infection
4. DThe initial admission assessment of a new patient with suspected sepsis

A patient’s fasting glucose today is 98 mg/dL (5.4 mmol/L), but the HbA1c is 8.9% (74 mmol/mol). What is the best interpretation?

1. AThe patient does not have diabetes
2. BThe HbA1c reflects only the past 24 hours
3. CToday’s good result shows that diabetes is well controlled
4. DGlucose control has been poor over the past 2–3 months

An older adult has bone pain, fatigue and frequent infections. Results show anemia, a calcium of 12.4 mg/dL (3.1 mmol/L), a raised total protein and a rising creatinine. Which condition should be suspected?

1. AIron-deficiency anemia
2. BPrimary hypothyroidism
3. CAcute viral hepatitis
4. DMultiple myeloma

Which is a recognised risk factor for postoperative nausea and vomiting?

1. AA short operation under local anaesthetic
2. BUse of opioids after surgery
3. CBeing male
4. DBeing a smoker

A patient after abdominal surgery has not passed urine for eight hours, has lower abdominal discomfort and a palpable bladder. What is the most likely problem?

1. AAcute kidney injury with no urine production
2. BUrinary tract infection without retention
3. CAcute urinary retention
4. DDehydration only

Why does a large, rapidly forming pericardial effusion lower the blood pressure?

1. AIt dilates the arteries throughout the body
2. BIt makes the heart muscle contract too strongly and too fast
3. CIt compresses the heart and stops the ventricles filling
4. DIt causes the aortic valve to leak backwards into the ventricle

A breathless patient on a non-rebreather mask at 15 L/min has a reservoir bag that collapses completely with each breath. What should the nurse do?

1. ARemove the bag, as the mask works without it
2. BCheck the oxygen supply and flow so the bag stays inflated
3. CLeave it, because a collapsing bag shows a good seal
4. DReduce the flow to 2 L/min to stop the bag collapsing

After a kidney biopsy, which observation is most important?

1. AThe patient's appetite at the next meal
2. BThe temperature every four hours only
3. CSigns of bleeding, such as haematuria and a rising pulse
4. DThe colour of the patient's skin on the face

A patient's potassium is 7.1 mmol/L, and the ECG shows peaked T waves and broad QRS complexes. What is the first treatment?

1. AOral potassium binder
2. BOral sodium bicarbonate
3. CIV furosemide
4. DIV calcium gluconate

Which intervention most reduces pressure ulcer risk in an immobile patient?

1. AUsing a doughnut-shaped ring cushion
2. BMassaging red areas firmly at each turn to bring back the circulation
3. CRegular repositioning and a pressure-redistributing mattress
4. DKeeping the head of the bed raised at 90° all day

During an IV vincristine infusion through a peripheral cannula, the patient reports burning, and the site is swollen. What should the nurse do first?

1. AFlush the cannula with saline to push the remaining drug into the vein
2. BContinue the infusion more slowly and apply an ice pack to the site
3. CStop the infusion, leave the cannula to aspirate, follow the policy
4. DRemove the cannula at once and massage the area to spread the drug