NCLEX 形式の優先順位の決定と委任：直前対策パック

Two nursing assistants argue loudly at the station about their assignments. What is the charge nurse’s best first step?

1. AIgnore it and hope they sort it out
2. BReport them to human resources at once
3. CMeet both of them privately to hear each side
4. DChange both of their assignments without any discussion

A patient taking an MAO inhibitor antidepressant is taught about diet. Which statement shows a need for further teaching?

1. A“A sudden severe headache is a warning sign.”
2. B“I will avoid tap beer and red wine.”
3. C“I can still eat aged cheese and cured salami.”
4. D“I will check with the pharmacist before cold remedies.”

hydrOXYzine と hydrALAZINE のような「トールマン表記」の目的は何ですか？

1. A商品名を示すこと
2. B似た名前の薬を見分けやすくすること
3. C薬の規格（含量）を示すこと
4. D2つの薬のうちどちらがハイリスク薬かを示すこと

During a disaster, the hospital needs to free beds quickly. Which patient is the best candidate for early discharge?

1. AA patient on a ventilator in the intensive care unit who is slowly improving
2. BA patient with ongoing chest pain awaiting cardiac tests
3. CA patient on an IV heparin infusion that is still being adjusted
4. DA patient admitted overnight for observation who is now stable with normal tests

An older adult with chronic kidney disease starts trimethoprim-sulfamethoxazole for a urinary tract infection. Which electrolyte should be monitored closely?

1. ASodium, because the drug causes heavy sodium retention
2. BChloride, because the drug causes chloride loss
3. CPotassium, because trimethoprim can raise it
4. DCalcium, because the drug binds calcium in the gut

After a crush injury, a patient's urine dipstick is strongly positive for blood, but microscopy shows almost no red cells. CK is very high. What best explains this?

1. AA kidney stone is scraping the ureter lining
2. BThe sample was contaminated with menstrual blood
3. CMyoglobin from damaged muscle is in the urine
4. DBleeding is coming from the bladder lining

An older adult has left lower abdominal pain, fever and a raised CRP. Which condition is most likely?

1. AGastric ulcer
2. BAppendicitis
3. CDiverticulitis
4. DBiliary colic

Why must severe chronic hyponatraemia be corrected slowly?

1. ASodium given quickly causes immediate cardiac arrest
2. BFast correction makes the kidneys stop producing urine
3. CFast correction causes severe hypoglycaemia and seizures in most patients
4. DToo-rapid correction can cause osmotic demyelination in the brain

A patient's ankle–brachial pressure index (ABPI) is 0.6. What does this suggest?

1. AA deep vein thrombosis
2. BSignificant peripheral arterial disease
3. CNormal leg circulation
4. DStiff, calcified arteries that read falsely high

Which instruction from the registered nurse to a healthcare assistant (unlicensed assistive personnel) caring for a patient with COPD is most appropriate?

1. A"Teach him how to use his new inhaler this afternoon after his rest."
2. B"Listen to his chest after lunch and let me know what you can hear."
3. C"Turn his oxygen up to whatever he needs if he looks short of breath."
4. D"Tell me straight away if his SpO₂ is under 88% or he is more breathless."

How does bladder training help urge incontinence?

1. AThe patient drinks as little as possible
2. BThe patient goes to the toilet every 15 minutes
3. CThe time between voids is slowly increased
4. DA catheter is used every night

バルプロ酸を服用しているてんかんの女性が、妊娠を計画していると言いました。最も適切な対応はどれですか？

1. Aバルプロ酸は妊娠中ずっと安全だと安心させる
2. B急に中止しないよう助言し、専門医の緊急の診察を受けてもらう
3. C赤ちゃんを発作から守るために、用量を2倍にするよう提案する
4. D今日からバルプロ酸を完全に中止するよう伝える

多角的（マルチモーダル）鎮痛について正しい記述はどれですか？

1. Aより強い全体の効果のため、数種類のオピオイドを組み合わせる
2. B一度に投与してよい鎮痛薬は、1種類だけである
3. C作用の異なる薬を組み合わせて、オピオイドの必要量を減らす
4. D長期の慢性痛にのみ使われる方法である

Why is folinic acid (leucovorin) given after high-dose methotrexate?

1. ATo treat the patient's anaemia only
2. BTo rescue normal cells from methotrexate toxicity
3. CTo increase the anticancer effect on the tumour
4. DTo prevent hair loss during treatment