NCLEX 유형 우선순위 설정과 위임: 벼락치기 팩

간호사가 지난 한 시간 동안 혈압이 떨어지고 있는 환자의 일상적인 활력징후 측정을 간호조무사에게 위임합니다. 위임의 어느 권리가 충족되지 않았나요?

1. A올바른 사람
2. B올바른 업무. 활력징후는 결코 위임할 수 없기 때문이다
3. C올바른 지시와 의사소통
4. D올바른 상황

Using ESI, a stable adult with abdominal pain will need blood tests and a CT scan, but has a heart rate of 130/min. Which statement is correct?

1. AVital signs never change the ESI level
2. BThe patient is level 4 because the blood tests and the scan count as one resource
3. CThe nurse should consider level 2 because of the danger-zone vital sign
4. DThe patient is level 5 because the pain is not severe

Which instruction about using a standard walker is correct?

1. ACarry the walker and use it only when tired
2. BMove the walker forward, then step into it
3. CWalk well ahead of the walker for balance
4. DPush up from the walker to stand from a chair

백일해가 의심되는 환자가 1인실이 없어 다인실에 있어야 합니다. 감염관리팀에 연락하는 동안 가장 적절한 배치는?

1. A모두 N95 호흡보호구를 착용하는 공기주의를 적용한다
2. B환자를 면역저하 환자 옆에 둔다
3. C커튼을 치고, 1미터(3피트) 넘게 간격을 두고, 가까이 접촉할 때 마스크를 착용한다
4. D1인실이 날 때까지 아무 주의도 적용하지 않는다

A patient is on an IV insulin infusion protocol in the ICU. How often is the blood glucose usually checked?

1. AOnly if symptoms occur
2. BAbout every hour
3. COnce a day before breakfast
4. DOnce every 12 hours

A patient with kidney stones and fatigue has a calcium of 11.6 mg/dL (2.9 mmol/L), a high parathyroid hormone (PTH) and a low phosphate. Which condition is most likely?

1. AHypoparathyroidism
2. BCancer-related hypercalcemia
3. CPrimary hyperparathyroidism
4. DVitamin D deficiency

A pressure ulcer shows full-thickness tissue loss with exposed bone. Which category (stage) is this?

1. ACategory 3
2. BCategory 2
3. CCategory 4
4. DCategory 1

Which type of drug is commonly used to treat neuropathic pain?

1. AAntibiotics such as amoxicillin, given as a long course
2. BProton pump inhibitors such as omeprazole
3. CSome anticonvulsants or antidepressants, such as gabapentin
4. DAntihistamines such as cetirizine

Why must anti-embolism stockings be measured and fitted correctly?

1. ATight stockings work better, so the smallest size is always best
2. BLoose stockings make the patient's legs too warm at night
3. CPoorly fitting stockings can cause pressure damage
4. DCorrect fit is needed only to improve the appearance

Which task for a stable patient with heart failure can the registered nurse most appropriately delegate to a healthcare assistant (unlicensed assistive personnel)?

1. ATeaching the patient about a low-salt diet
2. BMeasuring and recording the morning weight
3. CAssessing lung sounds for new crackles
4. DDeciding whether to give the furosemide dose

A patient with atrial fibrillation has had an ischaemic stroke. Which long-term medicine type most reduces the risk of another stroke?

1. AA beta-agonist inhaler
2. BAn oral anticoagulant
3. CA proton pump inhibitor
4. DA loop diuretic

A patient taking an SGLT2 inhibitor is booked for major surgery. Which statement is correct?

1. AIt is usually paused in the days before surgery
2. BSurgery is not possible in patients taking this drug
3. CThe dose is usually doubled on the morning of surgery
4. DThe drug must be taken right up until the operation starts

복수를 추적하는 데 쓰는 침상 평가는?

1. A매일 체중과 복부 둘레
2. B매 식사 전 모세혈관 혈당
3. C하루 두 번 동공 크기와 반응
4. D최대 호기 유속과 산소포화도

A patient with advanced cancer who has capacity decides to stop chemotherapy. The family insists that treatment must continue. What should the nurse do?

1. ASupport the patient's decision and help the team talk with the family
2. BAsk the family to sign a new consent form
3. CContinue treatment because the family has asked for it
4. DTell the patient that stopping is not allowed