NCLEX 유형 우선순위 설정과 위임: 벼락치기 팩

A patient is raising his voice, pacing and clenching his fists. What should the nurse do first?

1. ASpeak calmly, keep a safe distance and invite him to talk about what is wrong
2. BApply physical restraints at once
3. CTurn away and ignore the behavior
4. DStand very close to him and tell him firmly and loudly to sit down and be quiet

A patient with anorexia nervosa is admitted. Which finding is the priority?

1. ASays she feels fat although she is very thin
2. BRefuses to eat in front of other people
3. CHeart rate 38/min and potassium 2.8 mEq/L
4. DHas fine, downy hair on her arms

Why is “QD” (once daily) on The Joint Commission’s “Do Not Use” list?

1. AIt is a Latin abbreviation, and only plain English abbreviations may be used
2. BIt can be misread as QID or QOD, so the drug is given too often or too rarely
3. CIt means “every day at bedtime” in some hospitals
4. DIt is only allowed for intravenous medicines

A nurse teaches a patient going home with an MRSA wound infection. Which statement shows a need for further teaching?

1. A“I will put used dressings in a sealed bag before throwing them out.”
2. B“I can share towels with my family if I wash them every week.”
3. C“I will keep the wound covered with a clean, dry dressing.”
4. D“I will wash my hands after touching my dressing.”

A patient is starting atorvastatin. Which laboratory test is usually checked at baseline?

1. ASerum lipase
2. BLiver enzymes
3. CBlood cultures
4. DThyroid antibodies

A patient with a heart murmur and fever has three sets of blood cultures, taken hours apart, all growing the same Streptococcus species. What does this suggest?

1. AA urinary tract infection that has spread to the skin
2. BContamination of all three samples during collection
3. CA normal finding in patients with heart murmurs
4. DPersistent bacteremia, as in infective endocarditis

Why is lactulose given to a patient with hepatic encephalopathy?

1. ATo lower the blood glucose
2. BTo stop bleeding from varices
3. CTo increase the liver's production of albumin
4. DTo reduce the absorption of ammonia from the gut

A patient two days after abdominal surgery coughs and says something "gave way". The wound has opened and bowel is visible. What should the nurse do first?

1. ASit the patient fully upright and offer a hot drink
2. BApply dry gauze tightly and ask the patient to keep coughing
3. CGently push the bowel back into the abdomen and tape the wound edges firmly closed
4. DCover the wound with sterile, saline-moistened dressings and get urgent surgical help

천식 환자가 일주일에 세 번 넘게 속효성 흡입기를 사용합니다. 이는 무엇을 시사합니까?

1. A예방 흡입기는 더 이상 필요하지 않다
2. B천식 조절이 불량하여 치료를 재검토해야 한다
3. C속효성 흡입기가 더는 듣지 않으므로 중단해야 한다
4. D현재 계획으로 천식이 잘 조절되고 있다

A heavy smoker is having surgery tomorrow and asks whether stopping smoking now is pointless. Which reply is most accurate?

1. AStopping even today lowers carbon monoxide levels before surgery
2. BIt is pointless unless they stopped smoking at least a year ago
3. CStopping now will make the operation more dangerous
4. DSmoking before surgery protects the lungs from the anaesthetic gases

An older patient with a long-term catheter has bacteria in the urine but no symptoms. What is usually appropriate?

1. AAntibiotics for life to keep the urine sterile
2. BNo antibiotics, as long as there are no symptoms
3. CA full course of antibiotics straight away
4. DRemove the catheter permanently at once

A patient on carbamazepine is admitted confused, with a sodium of 121 mmol/L. Which explanation is most likely?

1. ACarbamazepine can cause hyponatraemia through an SIADH-like effect
2. BThe low sodium proves the patient has stopped taking the drug
3. CConfusion is a normal, expected effect of carbamazepine and is unrelated to sodium
4. DCarbamazepine causes salt loss through severe diarrhoea

경증 급성 췌장염에서 영양 공급에 대해 현재 지침에 맞는 설명은?

1. A환자는 정맥 영양으로만 영양을 공급해야 한다
2. B통증과 구역이 허용하면 경구 영양을 일찍 재개할 수 있다
3. C아밀라아제가 정상으로 돌아올 때까지 음식을 주지 않는다
4. D췌장을 쉬게 하려면 최소 3주 동안 금식해야 한다

A patient on warfarin has a major upper GI bleed with an INR of 5. Which treatment should the nurse anticipate to reverse the warfarin?

1. AOral aspirin to balance the clotting system quickly
2. BMore warfarin to stabilise the INR
3. CProtamine sulfate on its own
4. DProthrombin complex concentrate with IV vitamin K