NCLEX tipo prioritetų nustatymas ir delegavimas: pasiruošimo paketas

Several patients on a gastroenterology unit need care. Which patient should the nurse see first?

1. ALong-standing back pain, asking for the usual analgesic
2. BTwo hours after a colonoscopy: rigid abdomen and severe new pain
3. CCrohn disease, waiting to be taken down for a scheduled CT scan
4. DUlcerative colitis, asking about diet changes for home

A nurse must care for a patient with a radioactive implant. Which approach best limits the nurse’s exposure?

1. ALimit time in the room, keep as far away as possible and use shielding
2. BWear a surgical mask to block the radiation
3. CStand close to the patient to finish care faster
4. DSpend longer in the room each time but visit less often during the shift

Kada slaugytojas gali naudoti gesintuvą gaisrui gesinti?

1. ANiekada; gesintuvus gali naudoti tik ugniagesiai
2. BTik jei gaisras nedidelis, pavojus paskelbtas ir išėjimas laisvas
3. CVisada, net prieš paskelbiant pavojų, kad sutaupytų laiko
4. DKai tik yra dūmų, net jei išėjimas užblokuotas

During a procedure, a nurse sees that the team is about to start without a time-out. What should the nurse do?

1. ASpeak up clearly and stop the start until the time-out is done
2. BWait and raise the issue after the procedure is finished
3. CSay nothing, because the surgeon is responsible for the procedure
4. DReport it to the manager at the end of the week

Pacientui, vartojančiam varfariną dėl prieširdžių virpėjimo, INR yra 5,2 ir kraujavimo nėra. Koks geriausias slaugytojo veiksmas?

1. ASulaikyti varfarino dozę ir informuoti skiriantįjį gydytoją
2. BPatarti pacientui nuo šiandien nebevalgyti žaliųjų daržovių
3. CDuoti įprastą dozę ir pakartoti tyrimą po mėnesio
4. DDuoti dvigubą dozę

A nursing student has a positive interferon-gamma release assay (IGRA) for tuberculosis, no symptoms and a normal chest X-ray. What does this most likely mean?

1. ALatent TB infection, which is not contagious
2. BA false result, as the test does not detect TB
3. CPast BCG vaccination only, with no infection
4. DActive pulmonary TB, which is contagious

A nurse suspects that an older patient is being financially abused by a relative. What should the nurse do?

1. AKeep it secret because it is a family matter
2. BRaise the concern through the local safeguarding (adult protection) procedure
3. CConfront the relative directly at the bedside about it
4. DWait until the patient has been discharged

A hypotensive postoperative patient is given a fluid bolus. Which findings suggest a good response?

1. AThe heart rate rises further and the patient becomes more confused
2. BThe heart rate falls, blood pressure rises and urine output improves
3. CThe respiratory rate rises and new lung crackles appear
4. DThe capillary refill time becomes longer

What is the purpose of cardiac resynchronisation therapy (a biventricular pacemaker)?

1. ATo replace a damaged heart valve
2. BTo slow the atrial rate in patients with atrial fibrillation
3. CTo deliver a shock whenever the heart rate exceeds 100/min
4. DTo make both ventricles contract together and more efficiently

A patient with severe COPD has increasing ankle oedema and a raised JVP, but no crackles and a normal left ventricle on echocardiography. Which condition is most likely?

1. ADeep vein thrombosis
2. BAortic stenosis
3. CCor pulmonale
4. DLeft ventricular failure

Which signs suggest rejection of a kidney transplant?

1. AA rash on the face after sun exposure
2. BMore urine, a falling creatinine and weight loss
3. CLess urine, a rising creatinine and a tender graft
4. DA cough, wheeze and a runny nose with sneezing

A kidney transplant recipient has had vomiting and diarrhoea for two days. Why should the transplant team be contacted?

1. AThe kidney will start to produce far too much urine
2. BThe patient may not be absorbing their immunosuppressants
3. CThe tablets will make the vomiting stop
4. DVomiting proves that rejection has already happened

Kas yra naviko irimo sindromas?

1. AMetabolinė skubi būklė dėl greito vėžio ląstelių irimo
2. BAlerginė reakcija į chemoterapijos infuziją
3. CLėtai augantis auglys, spaudžiantis nervus
4. DOdos reakcija neseniai spinduliuota srityje

A category (stage) 4 pressure ulcer is now healing and shallower. How should it be documented according to standard guidance?

1. AAs a healing category 4 pressure ulcer
2. BAs a fully healed ulcer that can be removed from the record
3. CAs a category 2 pressure ulcer now
4. DAs a category 1 pressure ulcer now