NCLEX 形式の優先順位の決定と委任：直前対策パック

A patient is booked for a CT scan with iodinated contrast. Which of the patient’s medications may need to be held according to protocol?

1. AOmeprazole
2. BAcetaminophen (paracetamol)
3. CMetformin
4. DLevothyroxine

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, because the provider gave the instruction
4. DDo it just this once and promise the provider not to do it again

Why should a child’s weight be recorded only in kilograms?

1. AMixing up pounds and kilograms can lead to large dosing errors
2. BKilograms are easier for parents to remember
3. CChildren weigh less, so smaller units are needed
4. DScales that show kilograms are always more accurate than those that show pounds

看護師が、同僚が手指衛生をせずに患者から次の患者へ移るのを目にしました。最善の対応はどれですか？

1. A1か月後に匿名で管理者に報告する
2. Bチーム内の対立を避けるため、何も言わない
3. Cすぐに同僚へ丁寧に注意を促す
4. D次回はするかどうか様子を見る

A patient has a hot, swollen big toe. The serum uric acid is normal. Which statement is correct?

1. AGout is still possible, as urate can be normal in an attack
2. BGout is certain, as a normal urate proves the diagnosis
3. CGout is ruled out, as uric acid is always high in an attack
4. DGout can only be diagnosed with a CT scan of the foot

The nurse prepares a patient for a 2-hour oral glucose tolerance test tomorrow morning. Which statement shows a need for further teaching?

1. A"I'll fast overnight but can drink plain water"
2. B"I can have a light breakfast before the test"
3. C"I'll stay seated during the test if I can"
4. D"I'll avoid smoking until the test is over"

2 型糖尿病の患者が急に具合が悪くなり、強い脱水があり、血糖は 40 mmol/L ですが、ケトンはほとんどありません。最も考えられる診断は？

1. A尿崩症
2. B高浸透圧高血糖状態
3. C脱水を伴う糖尿病性ケトアシドーシス
4. D低血糖

An older man has sudden severe abdominal and back pain, is hypotensive and has a pulsating mass in the abdomen. What should be suspected?

1. AMusculoskeletal back pain
2. BA ruptured abdominal aortic aneurysm
3. CAcute gastritis from anti-inflammatory drugs
4. DRenal colic from a kidney stone

A 70 kg patient has passed 20 mL of urine per hour for the last three hours. How should this be interpreted?

1. ANormal, because any measurable urine output is reassuring
2. BHigh, suggesting fluid overload that needs a diuretic
3. CBelow 0.5 mL/kg/h, suggesting poor kidney perfusion
4. DNormal, because the target is 0.1 mL/kg/h

Twelve hours after a coronary stent, a patient has sudden severe chest pain again with new ST elevation in the same leads. What is the most likely cause?

1. ANormal pain from the procedure site
2. BAcute stent thrombosis
3. CIndigestion from the hospital meal
4. DPericarditis from the catheter

グラルギンなどの持効型基礎インスリンについて正しい記述はどれですか？

1. A注射の約30分後に、鋭い作用のピークがある
2. B1型糖尿病では、食事をとらないときでも続ける
3. C炭水化物をカバーするため、大きな食事の後にのみ投与する
4. D超速効型インスリンと同じ注射器で混ぜる

A patient with stable epilepsy on phenytoin started a new medicine last week. They now have nystagmus, an unsteady gait and slurred speech. What should the nurse do?

1. ASuspect phenytoin toxicity, hold the next dose and ask for a drug level
2. BGive the next phenytoin dose early to prevent a seizure
3. CSuspect a new stroke and give aspirin straight away before any scan
4. DEncourage the patient to walk more to improve their balance

Why is a gastrostomy tube with an internal bumper usually advanced and rotated regularly once the tract has healed?

1. ATo make the tube longer as the patient grows or gains weight
2. BTo remove any feed left in the stomach
3. CTo check that the patient is still hungry
4. DTo stop the inner bumper becoming buried in the stomach wall

A patient with a platelet count of 8 × 10⁹/L (8,000/µL) develops a sudden severe headache and confusion. What should the nurse suspect?

1. ADehydration from poor intake
2. BIntracranial bleeding
3. CA tension headache from stress
4. DNormal effects of chemotherapy