NCLEX 形式の優先順位の決定と委任：直前対策パック

A parent of a child with influenza talks with the nurse. Which statement shows a need for further teaching?

1. A“I will give my child plenty of fluids.”
2. B“I will give my child aspirin to bring the fever down.”
3. C“I will keep my child home from school and away from others while unwell.”
4. D“I will call if my child has trouble breathing.”

An RN sees an LPN/LVN crushing an extended-release metoprolol tablet to mix with applesauce. What should the RN do?

1. AStop the LPN/LVN and contact the prescriber or pharmacist about another form
2. BLet the LPN/LVN continue, since crushing makes the tablet easier to swallow
3. CTell the LPN/LVN to give half of the crushed tablet now and the other half at lunchtime
4. DReport the LPN/LVN at the end of the month without saying anything now

When should blood specimen tubes be labeled?

1. ABy the laboratory staff after the tubes arrive
2. BAt the bedside, in front of the patient, right after collection
3. CBack at the station after all the samples are collected
4. DAt the nurses’ station before going to the patient, to save time

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

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

A patient's potassium is 7.0 mEq/L. Which ECG change would the nurse expect?

1. ATall, peaked T waves
2. BDelta waves before the QRS
3. CProminent U waves
4. DFlattened T waves

An 82-year-old woman without a catheter has a urine culture growing bacteria, but no fever, urinary symptoms or change in mental state. What is the best interpretation?

1. AContamination, so the culture must be repeated every week
2. BA urinary tract infection that needs urgent IV antibiotics
3. CPyelonephritis, which needs admission and IV fluids today
4. DAsymptomatic bacteriuria, usually not treated with antibiotics

Which blood results are typical of Addison's disease (primary adrenal insufficiency)?

1. ALow sodium and high potassium
2. BHigh sodium and low potassium
3. CHigh glucose and high calcium
4. DLow haemoglobin and high platelets

Why is morphine more likely to cause toxicity in a patient with severe kidney impairment?

1. AKidney disease makes the opioid receptors disappear
2. BKidney failure makes the stomach absorb more morphine
3. CIts active metabolites build up because the kidneys excrete them
4. DThe kidneys normally activate morphine, so more of it becomes active

Which feature of a COPD exacerbation most suggests that antibiotics are needed?

1. AA clear runny nose
2. BA dry, tickly cough with no sputum at all for a day
3. CAn increase in purulent (green or yellow) sputum
4. DA mild sore throat that lasted for one day only

1日1.5 Lの水分制限を受けている心不全の患者が、強い口渇を訴えています。最も適切な対応はどれですか？

1. A口腔ケア、数を数えた氷片、1日を通して分けた水分
2. B翌朝の体重測定まで、一切の水分を与えない
3. C唾液を促して乾燥を和らげるための、塩気のある軽食
4. D渇きは常に満たすべきなので、水を無制限に

Which measure best prevents catheter-associated urinary tract infection?

1. ADisconnect the bag regularly to empty it
2. BChange the catheter for a new one every day
3. CKeep the drainage bag above bladder level
4. DRemove the catheter as soon as it is no longer needed

Which patient with a spinal cord injury is at risk of autonomic dysreflexia?

1. AA patient with an injury at L3
2. BA patient with an injury at S2
3. CA patient with an injury at T4
4. DA patient with an injury at L5

Which finding means a patient is usually ready to leave recovery for the ward?

1. AStill drowsy and needing a jaw thrust to breathe
2. BPain score 9/10 and vomiting repeatedly
3. CSystolic BP falling steadily over the last hour, with a rising pulse rate
4. DAwake, with a clear airway, stable observations and controlled pain

A patient on immunotherapy for melanoma has six watery stools a day and abdominal cramps. What should the nurse do?

1. AReassure that diarrhoea is normal and harmless
2. BAdvise eating more fibre and fruit to firm up the stools
3. CGive loperamide and review next week
4. DEscalate urgently, as immune-related colitis is likely