NCLEX tipo prioritetų nustatymas ir delegavimas: pasiruošimo paketas

A nurse has given rapid-acting insulin, and then learns that the patient’s meal tray will be 45 minutes late. What should the nurse do?

1. AGet the patient some carbohydrate food now and check the glucose
2. BGive a second, smaller dose of insulin when the meal tray finally arrives
3. CAsk the patient to walk around the ward until the food arrives
4. DTell the patient to wait and do nothing until the tray comes

A patient has central chest pain that started 30 minutes ago at rest and has not eased with rest or nitroglycerin. What does this suggest?

1. AA possible myocardial infarction that needs urgent action
2. BIndigestion that is best treated with an antacid and a glass of milk
3. CMuscle strain that needs a warm compress
4. DStable angina that will pass without treatment

Why are blood cultures usually taken from two separate venipuncture sites?

1. ATo reduce the total amount of blood taken
2. BTo make the results come back faster from the laboratory
3. CBecause each site tests a different antibiotic
4. DTo help tell a true infection from skin contamination

Over a few hours, the emergency department sees many previously healthy people with the same unusual severe symptoms. What should the nurse do?

1. ATreat each patient and wait to see if more arrive next week
2. BReport it to infection prevention and public health authorities promptly
3. CTell only the patients’ families about the pattern
4. DSend the patients home quickly to avoid crowding the emergency department

Why must a blue-top (citrate) coagulation tube be filled to the correct level?

1. AAn overfull tube is needed to measure the potassium level
2. BThe blood-to-anticoagulant ratio must be right for accurate clotting times
3. CThe laboratory charges extra when a tube is not filled correctly
4. DUnderfilled tubes always give a falsely low hemoglobin and hematocrit

Two weeks after a sore throat, a child develops dark (cola-colored) urine, puffy eyes and high blood pressure. Urinalysis shows red cell casts and protein. Which condition is most likely?

1. APost-streptococcal glomerulonephritis
2. BLower urinary tract infection (cystitis)
3. CPrerenal acute kidney injury
4. DKidney stone in the ureter

What is one advantage of a direct oral anticoagulant (DOAC) such as apixaban compared with warfarin?

1. AIt has no risk of bleeding
2. BIt does not need routine INR monitoring
3. CIt is safe in all patients with severe kidney failure
4. DIt never interacts with other drugs

A patient with suspected appendicitis says the pain suddenly eased, but an hour later has pain all over the abdomen, a rigid abdomen and a fever. What is most likely?

1. AThe analgesia has started working
2. BThe patient has developed gastroenteritis
3. CThe appendicitis has resolved without treatment
4. DThe appendix has perforated, causing peritonitis

What is the main problem in heart failure with preserved ejection fraction?

1. AA dilated ventricle that cannot contract strongly
2. BA leaking aortic valve
3. CA stiff ventricle that fills poorly in diastole
4. DA blocked pulmonary artery

A nurse looked after a patient for a shift before smear-positive pulmonary TB was diagnosed, without wearing a respirator. What should happen?

1. AReport it so occupational health can arrange follow-up screening
2. BStart a full six-month course of TB drugs at once without any tests
3. CTake no action, as healthcare workers are immune to TB
4. DStay off work for six months in case symptoms develop

A patient with gout has recurrent uric acid kidney stones. Which treatment helps prevent them?

1. AVitamin C supplements and a high-meat diet
2. BAllopurinol and making the urine less acidic
3. CRestricting fluids in the evening only
4. DCalcium tablets and a low-fluid diet

A man who takes tamsulosin for BPH is listed for cataract surgery. Which statement is correct?

1. AIt should be swapped for oxybutynin the night before to protect the eye
2. BThe dose should be doubled before surgery to prevent urinary retention
3. CTamsulosin has no effects outside the urinary tract, so nothing changes
4. DThe eye surgeon must be told, as it can cause floppy iris during surgery

Why are antibody levels checked after a healthcare worker receives the hepatitis B vaccine?

1. ATo decide whether they need a liver biopsy
2. BTo measure liver damage caused by the vaccine
3. CTo confirm that the vaccine produced immunity
4. DTo check whether they caught hepatitis B from the vaccine

On day 5 after bowel resection, a patient has a fever, tachycardia and worsening abdominal pain, and the drain contains brown, faeculent fluid. What is most likely?

1. AAn anastomotic leak
2. BPostoperative constipation
3. CA normal day 5 recovery
4. DA urinary tract infection