NCLEX 形式の優先順位の決定と委任：直前対策パック

A drowsy patient has an arterial blood gas with pH 7.30, PaCO₂ 58 mmHg (7.7 kPa) and HCO₃⁻ 25 mEq/L (mmol/L). Which problem is the priority?

1. AToo much bicarbonate from antacids
2. BHyperventilation caused by anxiety
3. CPoor ventilation causing carbon dioxide to build up
4. DLoss of bicarbonate from the bowel through severe diarrhea

After the RN taught a patient to inject insulin, an LPN/LVN reports that the patient still cannot draw up the dose correctly. What should happen next?

1. AThe patient is discharged with a leaflet to read at home
2. BThe nursing assistant shows the patient again at lunch
3. CThe LPN/LVN writes a new teaching plan and evaluates it at the end of the shift
4. DThe RN reassesses the patient’s learning needs and adjusts the teaching

Where should the drainage bag of an indwelling urinary catheter be kept?

1. AOn the floor under the bed, where it is out of the way
2. BBelow the level of the bladder and off the floor
3. COn the bed next to the patient’s hip
4. DHung on the IV pole above the patient

Victims of a chemical spill arrive at the emergency department with liquid on their skin and clothing. What is the priority before they enter the building?

1. ADecontaminate them outside, with staff wearing appropriate PPE
2. BGive them hospital gowns and seat them in triage
3. CTake them straight into the resuscitation room so treatment is not delayed
4. DTake a full history in the waiting room

A stool test for Clostridioides difficile is ordered. Which sample is appropriate?

1. AA formed, hard stool sample
2. BAny stool after a laxative dose
3. CA rectal swab from a patient with constipation
4. DAn unformed (liquid or soft) stool

4 つの検査結果が届きました。看護師が最初に対応すべきものはどれですか？

1. A慢性腎臓病患者のヘモグロビン 11.8 g/dL（118 g/L）
2. B昨日肺炎で入院した患者のナトリウム 137 mEq/L
3. C糖尿病患者の食後血糖 140 mg/dL（7.8 mmol/L）
4. D新たな筋力低下がある CKD 患者のカリウム 6.6 mEq/L

A patient on insulin reports nightmares, night sweats and morning headaches. What should be suspected?

1. AA urinary tract infection
2. BHyperthyroidism
3. CNight-time hypoglycaemia
4. DRaised intracranial pressure

Why are early surgery and early mobilisation recommended for older patients with a hip fracture?

1. AThey allow the bone to heal fully without any need for pain relief
2. BThey mainly reduce the cost of the operation
3. CThey reduce complications such as pneumonia, pressure ulcers and delirium
4. DThey make physiotherapy and rehabilitation unnecessary after discharge

Why is aspirin chewed rather than swallowed whole in a suspected acute coronary syndrome?

1. AChewing stops the aspirin from irritating the lining of the stomach
2. BWhole aspirin tablets cannot be absorbed at all from the gut
3. CChewing speeds absorption, giving a faster antiplatelet effect
4. DChewing changes aspirin into an anticoagulant

A 70-year-old man has a small abdominal aortic aneurysm found on screening and is placed under surveillance. Which advice is most important?

1. AAvoid all exercise and lifting for the rest of his life to protect the aorta
2. BStop smoking, control BP and seek help at once for sudden back pain
3. CStop all blood pressure medicines to avoid low pressure
4. DHave the aneurysm repaired immediately, whatever its size or growth rate

DKAに静注インスリンを投与するとき、カリウムを注意深くモニタリングしなければならないのはなぜですか？

1. ADKAでは、インスリンはカリウムに影響しないから
2. Bインスリンはカリウムを細胞内に移動させるため、値が急速に低下しうるから
3. Cインスリンは血流中でカリウムを分解するから
4. Dインスリンは腎臓にカリウムを保持させるため、値が上昇するから

Which patient on a stroke unit is most at risk of falling?

1. AA patient with a right-hemisphere stroke who is impulsive and denies having weakness
2. BA patient with a left-hemisphere stroke who has expressive aphasia and waits for help
3. CA patient with a TIA whose symptoms resolved completely yesterday
4. DA patient with mild dysarthria who walks steadily with a frame

Why do patients with major burns lose so much fluid in the first 24–48 hours?

1. ALeaky capillaries let plasma move into the tissues
2. BThe kidneys stop making urine completely
3. CThe burned skin absorbs fluid from the air
4. DPatients drink far too little in hospital in the first days

On day 3 after laparoscopic cholecystectomy, a patient has abdominal pain, fever and mild jaundice, and green fluid is draining from the drain. What is most likely?

1. AA bile leak
2. BNormal post-operative drainage
3. CUrinary retention
4. DA wound haematoma