NCLEX tipo prioritetų nustatymas ir delegavimas: pasiruošimo paketas

A patient has a serum potassium of 2,9 mEq/L. Which finding should the nurse expect?

1. AA rise in urine output and thirst only
2. BMuscle weakness and U waves on the ECG
3. CTall, peaked T waves and muscle twitching
4. DFlushed, warm skin and a slow heart rate

A patient is admitted with suspected meningococcal meningitis. Which precautions are needed until treatment has been given for long enough?

1. AStandard precautions only
2. BDroplet precautions
3. CAirborne precautions
4. DContact precautions only

What is the main aim of purposeful hourly rounding?

1. ATo replace the need for a call light
2. BTo check pain, toileting, position and personal items before the patient needs to ask
3. CTo wake the patient every hour to check orientation
4. DTo count the patient’s medications every hour and check that none are missing

A nurse teaches a patient who has had a splenectomy. Which statement shows a need for further teaching?

1. A“Now that my spleen is out, a fever is nothing to worry about.”
2. B“I will get medical help quickly if I get a high temperature.”
3. C“I will tell all of my health care providers that I have no spleen.”
4. D“I will keep my vaccinations up to date.”

Which change in clotting tests is normal in late pregnancy?

1. APlatelets rise above 600 × 10³/µL
2. BINR rises to about 3,0
3. CFibrinogen and D-dimer rise
4. DaPTT doubles from baseline

A patient has taken metformin for 8 years and now has numbness in the feet, a hemoglobin of 10,2 g/dL (102 g/L) and an MCV of 108 fL. Which deficiency is most likely?

1. AVitamin K deficiency
2. BVitamin B₁₂ deficiency
3. CIron deficiency from gut loss
4. DVitamin D (calciferol) deficiency

During a red cell transfusion, when are serious acute reactions most likely to start?

1. AIn the first 15 minutes
2. BAbout 24 hours later
3. CAfter the third unit only
4. DOnly after the unit has finished

A patient with stress incontinence is taught self-care. Which statement shows a need for further teaching?

1. A"I'll try to lose some weight if I can."
2. B"I'll drink as little as possible so I don't leak."
3. C"I'll cut down on caffeine."
4. D"I'll do my pelvic floor exercises every day."

Monitoriuje matomas skilvelių virpėjimas. Pacientas nereaguoja ir nekvėpuoja normaliai. Koks pagrindinis gydymas?

1. AKuo greičiau atlikti gaivinimą (KPR) ir defibriliaciją
2. BSinchronizuota kardioversija taikant gilią sedaciją
3. CGreita adenozino injekcija į veną ir praplovimas
4. DAtropinas į veną ir išorinė stimuliacija

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

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

Which long-term risk should a kidney transplant recipient be taught to reduce with sun protection?

1. AKidney stones
2. BHair loss
3. CGout
4. DSkin cancer

A nurse teaches a woman with recurrent UTIs. Which statement shows a need for further teaching?

1. A"I will hold my urine for as long as I can."
2. B"I will pass urine soon after sex."
3. C"I will drink enough fluids during the day."
4. D"I will wipe from front to back."

Which lung problem is a known toxicity of bleomycin?

1. AAsthma from pollen
2. BPneumothorax from coughing
3. CLung cancer within weeks
4. DPulmonary fibrosis

After surgery, a patient keeps asking for analgesia before it is due, watches the clock and rates pain 8/10. What is the most appropriate interpretation?

1. AThe patient is exaggerating, so the pain scores should be ignored for now
2. BThe patient needs only distraction and no change in drugs
3. CThe patient is addicted and should have analgesia withheld
4. DPain may be undertreated; reassess and ask for a review of the plan