NCLEX 形式の優先順位の決定と委任：直前対策パック

A nurse teaches a patient to use an incentive spirometer. Which statement shows a need for further teaching?

1. A“I will try to hold my breath for a few seconds at the top.”
2. B“I will blow into it as hard and fast as I can.”
3. C“I will use it several times every hour while awake.”
4. D“I will breathe in slowly and deeply through the mouthpiece.”

A patient has a heart rate of 38/min, feels dizzy and has a blood pressure of 80/50 mmHg. Which drug is usually given first, as prescribed?

1. ADiltiazem
2. BDigoxin
3. CAtropine
4. DMetoprolol

A patient is on a ventilator. Which bed position helps to prevent ventilator-associated pneumonia?

1. ALying completely flat
2. BTrendelenburg position
3. CHead of the bed raised 30 to 45 degrees
4. DHead of the bed raised about 10 degrees

A nurse floated to an unfamiliar unit is asked to manage a device they have never been trained to use. What should the nurse do?

1. ADo it anyway, using only the device manual and the instructions on the screen
2. BAsk the patient or the family to explain how the device works
3. CTell the charge nurse and ask for help or a change of assignment
4. DLeave the device untouched and not tell anyone

ワルファリン服用中の患者が、毎日多量のケールとほうれん草を食べ始めました。INR が低下しました。最も適切な助言はどれですか？

1. A処方者に知らせずに、ワルファリンの用量を 2 倍にする
2. B緑色の野菜は二度と食べない
3. C食事が普通に戻るまでワルファリンをやめる
4. Dビタミン K を多く含む食品の摂取量を、日によって変えず一定に保つ

A patient with thalassemia major has received regular red cell transfusions for years. The ferritin is now very high. What does this most likely show, and what treatment is used?

1. AIron overload, treated with iron chelation therapy
2. BIron deficiency, treated with IV iron supplements
3. CLiver failure, treated with a liver transplant at once
4. DAcute infection, treated with broad-spectrum antibiotics

How is Helicobacter pylori infection usually treated?

1. AAntacids alone, taken after every meal for a month
2. BA combination of antibiotics with a proton pump inhibitor
3. CA single dose of paracetamol and a bland diet for a week
4. DSurgery to remove the stomach

A patient has a high fever with rigors, jaundice and right upper quadrant pain. Which condition is most likely?

1. AGastro-oesophageal reflux disease
2. BSimple biliary colic
3. CAscending cholangitis
4. DAcute appendicitis

胸腔ドレーンの液面が、動かなくなりました。何が考えられますか？

1. A室内の水位が高すぎて動けなくなった
2. Bドレナージユニットが腹部の排液を始めた
3. C反対側に新たな気胸が起きた
4. D肺が再膨張したか、チューブが折れ曲がっているか閉塞している

An older inpatient develops sudden fever, muscle aches and a dry cough during the winter influenza season. Which plan is most appropriate?

1. AIsolate with droplet precautions, test and expect early antivirals
2. BWait a week to see whether the symptoms settle before testing
3. CIsolate only if they develop a rash
4. DLeave them in the open bay and give a course of antibiotics only

A patient taking a GLP-1 receptor agonist has severe, constant upper abdominal pain spreading to the back, with vomiting. What should the nurse suspect?

1. ANormal nausea from the drug
2. BLow blood glucose
3. CA simple urinary tract infection
4. DAcute pancreatitis

A patient arrives five hours after the onset of a stroke. A CT angiogram shows a blockage of a large artery in the brain. What is the most appropriate next step?

1. AUrgent referral for assessment for mechanical thrombectomy
2. BGive aspirin and plan a review on the ward tomorrow
3. CNo treatment, because the time for any reperfusion has passed
4. DStart IV alteplase immediately without further imaging

How can low-dose opioids help a patient with breathlessness from advanced cancer?

1. AThey cure the underlying lung disease
2. BThey increase the oxygen level in the blood
3. CThey open the airways like an inhaler
4. DThey reduce the feeling of breathlessness

高悪性度リンパ腫の化学療法を開始した2日後、患者の尿量が減り、カリウムは6.4 mmol/L、リンは高く、カルシウムは低くなっています。看護師は何を疑い、どうすべきですか？

1. Aアレルギー反応で、抗ヒスタミン薬を投与して通常どおり続ける
2. B単純な脱水で、経口水分を促し、来週に血液検査を再確認する
3. C予想される化学療法の副作用で、次のサイクルまで対応は不要
4. D腫瘍崩壊症候群。上申し、心電図モニタリングを開始し、静注輸液を見込む