NCLEX-style Prioritization & Delegation: cram pack

Which action by a nursing assistant needs the nurse to step in?

1. ALowering the bed to its lowest position and locking the wheels after care
2. BCleaning hands before entering the room
3. CTaking an oral temperature just after the patient drank cold water
4. DPutting the call light within the patient’s reach

During surgery under general anesthesia, a patient develops rising end-tidal carbon dioxide, muscle rigidity and a rapidly increasing temperature. Which drug should the nurse anticipate?

1. AAtropine
2. BDantrolene
3. CFlumazenil
4. DNaloxone

Which patient has the highest risk of a burn from a heating pad?

1. AA patient with a sprained wrist who is fully alert
2. BA patient with diabetic peripheral neuropathy
3. CA healthy young adult with a strained muscle
4. DA patient recovering from a cold

A patient rescued from a house fire has a headache and confusion, but the pulse oximeter reads 99%. Why might this reading be misleading?

1. AThe reading is accurate, so carbon monoxide poisoning is ruled out
2. BPulse oximetry cannot tell carbon monoxide-bound hemoglobin from oxygen-bound hemoglobin
3. CConfusion and headache make pulse oximetry readings inaccurate in every patient
4. DPulse oximeters always read falsely low after any kind of smoke exposure

A stable adult who is not bleeding receives one unit of packed red cells. By about how much is the hemoglobin expected to rise?

1. AAbout 3 g/dL (30 g/L)
2. BAbout 1 g/dL (10 g/L)
3. CAbout 5 g/dL (50 g/L)
4. DAbout 0.1 g/dL (1 g/L)

An 82-year-old woman without a catheter has a urine culture growing bacteria, but no fever, urinary symptoms or change in mental state. What is the best interpretation?

1. AContamination, so the culture must be repeated every week
2. BAsymptomatic bacteriuria, usually not treated with antibiotics
3. CPyelonephritis, which needs admission and IV fluids today
4. DA urinary tract infection that needs urgent IV antibiotics

A patient with type 1 diabetes is vomiting and eating little. What is correct sick-day advice?

1. ACheck glucose once a day only
2. BStop insulin until eating normally again to avoid hypoglycaemia
3. CDo not stop insulin; check glucose and ketones more often
4. DHalve fluid intake to prevent vomiting

A patient with a confirmed pulmonary embolism is started on anticoagulation. Which statement best explains its purpose?

1. AIt is mainly given to lower the blood pressure
2. BIt dissolves the clot completely within minutes of the first dose being given
3. CIt thins the blood so that the lungs absorb more oxygen
4. DIt stops the clot growing and prevents new clots while the body breaks it down

Why is intravenous furosemide given slowly rather than as a rapid push of a large dose?

1. ARapid doses cause the potassium level to rise
2. BRapid doses cause severe constipation
3. CSlow injection makes the urine output larger
4. DRapid high doses can damage hearing

After six weeks of treatment for tuberculosis, a patient has nausea, dark urine and yellow eyes. What should the nurse do?

1. ADouble the isoniazid dose to clear the infection faster
2. BReassure the patient that the urine colour is due to rifampicin
3. CWithhold the next doses and report urgently for liver tests
4. DAdvise taking the tablets with an alcoholic drink to settle the stomach

A patient with AKI has a urinary catheter that drains nothing. Which quick bedside check helps rule out a post-renal cause?

1. AGive a large bolus of IV fluid straight away
2. BCheck the catheter for kinks or blockage and do a bladder scan
3. CSend a urine sample for culture and wait for the laboratory result
4. DEncourage the patient to drink two litres of water

The nurse has four patients with diabetes. Which one needs to be seen first?

1. AA patient with a glucose of 14 mmol/L (252 mg/dL) who feels well and is eating
2. BA patient waiting for a routine HbA1c test
3. CA newly diagnosed patient asking about which foods to eat
4. DA patient with a glucose of 2.8 mmol/L (50 mg/dL) who is sweaty and confused

Why should antacids usually be taken at a different time from other medicines?

1. AThey destroy other drugs before they are swallowed
2. BThey make all other drugs much more toxic
3. CThey stop the kidneys from clearing other drugs
4. DThey can reduce the absorption of many other drugs

A patient with long-standing chronic pancreatitis now has weight loss, thirst and passing large volumes of urine. What should the nurse check first?

1. ACapillary blood glucose
2. BSerum amylase level
3. CPeak expiratory flow
4. DAbdominal girth