NCLEX 形式の優先順位の決定と委任：直前対策パック

A patient receiving an aminoglycoside antibiotic, such as gentamicin, reports ringing in the ears. What should the nurse do?

1. AAdvise the patient to use ear drops
2. BReassure the patient that it is a normal effect
3. CHold the next dose and report it promptly
4. DGive the next dose early to finish the course

A patient with known abdominal aortic aneurysm suddenly has severe back pain, a pulsing mass in the abdomen and a falling blood pressure. What should the nurse do?

1. APalpate the mass firmly to check its size and spread
2. BCall for emergency help at once and prepare for urgent surgery
3. CEncourage the patient to walk to ease the back pain
4. DGive an oral analgesic and reassess the patient in about one hour

Which technique is correct when collecting a wound culture?

1. AUse one swab to sample two different wounds
2. BCollect the sample only after antibiotics have been started
3. CClean the wound with sterile saline first, then swab clean tissue
4. DSwab the old pus on the dressing that was just removed from the wound

急性の下痢で入院した患者に C. difficile 感染症が疑われます。検査結果は未着です。接触予防策はいつ開始しますか？

1. A患者が発熱したときだけ
2. B検査結果を待たず、直ちに
3. C下痢が3日続いた後
4. D検査結果が陽性で返ってきたときだけ

A patient starts high-dose prednisone. Which laboratory change should the nurse expect?

1. AA fall in serum sodium
2. BA rise in serum potassium
3. CA fall in the white cell count
4. DA rise in blood glucose

A patient with long-standing rheumatoid arthritis has a hemoglobin of 10.5 g/dL (105 g/L), a low serum iron, a low total iron-binding capacity (TIBC) and a high-normal ferritin. Which condition fits best?

1. AVitamin B₁₂ deficiency anemia
2. BAnemia of chronic disease (inflammation)
3. CAcute blood loss anemia
4. DIron-deficiency anemia

Why is an urgent brain scan needed before thrombolysis for a suspected stroke?

1. ATo measure the size of the ventricles
2. BTo check for brain tumours only
3. CTo rule out bleeding in the brain
4. DTo confirm the patient's age

Which patient should the nurse assess first?

1. AA postoperative patient who rates their pain as 6/10
2. BA patient with COPD whose SpO₂ is 89% and within their target range
3. CA patient with asthma who can only speak in single words
4. DA patient with diabetes whose glucose is 11 mmol/L (198 mg/dL) before lunch

胸痛のある患者がニトログリセリンを求めました。看護師が投与を保留して指示者に連絡すべきなのは、どの情報があるときですか？

1. A患者が今日の早い時間にシルデナフィルを服用した
2. B患者の血圧が150/90 mmHgである
3. C患者が先週頭痛を起こした
4. D患者が毎日スタチンを服用している

A patient with a confirmed pulmonary embolism has BP 78/50 mmHg despite fluids, and the right ventricle is dilated on echocardiography. Which treatment is most likely?

1. ACompression stockings and bed rest
2. BAn inhaled bronchodilator
3. CSystemic thrombolysis
4. DOral apixaban only, started next week

A patient with multiple sclerosis says their symptoms get worse after a hot bath. What should the nurse explain?

1. AHeat can briefly worsen MS symptoms, which settle when they cool down
2. BHot baths cause new areas of damage in the brain
3. CThey should take very cold baths to reverse the damage
4. DThis shows that the disease has entered a new progressive stage

A patient with hypopituitarism needs both hydrocortisone and levothyroxine. Which is usually started first?

1. ANeither, until symptoms appear
2. BHydrocortisone
3. CBoth on the same day, in any order
4. DLevothyroxine

Why is an ankle-brachial pressure index (ABPI) measured before compression bandaging for a leg ulcer?

1. ATo check for a leg bone fracture
2. BTo find the bacteria in the wound
3. CTo exclude significant arterial disease
4. DTo find out how deep the ulcer is

After signing the consent form, a patient tells the nurse, "I don't really understand what they are going to do." What should the nurse do?

1. AExplain the surgical risks in detail without involving the surgeon
2. BReassure the patient that the surgeon knows best
3. CIgnore the comment because the form is already signed
4. DInform the surgeon so that the procedure can be explained again