Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

On a postpartum unit, which patient is the most appropriate to assign to an LPN/LVN?

1. ADay 1 after an uncomplicated vaginal birth, stable vital signs
2. BOne hour after birth with heavy bleeding and a boggy uterus
3. CSevere pre-eclampsia on a magnesium sulfate infusion
4. DA new admission transferred from the labor ward with a fever of 38,6 °C

A charge nurse notices that a nurse smells of alcohol and is slurring words at the start of the shift. What is the priority?

1. ALet the nurse work, but only with stable patients
2. BRemove the nurse from patient care and report it according to policy
3. CWait until the end of the shift and then discuss the concern with the nurse privately
4. DAsk the nurse to drink coffee and then start work

A patient has fallen, and the nurse completes an incident report. Which statement about this report is correct?

1. AIt is only needed when the patient is injured
2. BIt replaces the need to document the fall in the patient’s record
3. CIt is written factually and does not replace documenting the fall in the patient’s record
4. DA copy of it is placed in the patient’s chart so all staff know about the fall

A patient punches a nurse during care. The nurse is not seriously hurt. What should the nurse do?

1. ASay nothing, because violence is part of the job
2. BRefuse to care for any patient for the rest of the week until the patient is moved
3. CGet medical assessment and report the assault according to policy
4. DPunch the patient back in self-defense

A patient without symptoms has a fasting plasma glucose of 132 mg/dL (7,3 mmol/L) on Monday and 138 mg/dL (7,7 mmol/L) on Thursday. What does this show?

1. AThe results are within the normal fasting range
2. BThe results show reactive hypoglycemia
3. CThe results meet the criteria for diabetes
4. DThe results show prediabetes only

A patient receiving parenteral nutrition with lipid emulsion has a triglyceride level of 620 mg/dL (7,0 mmol/L). Why is this result important?

1. AIt raises the risk of acute pancreatitis
2. BIt shows the nutrition is fully effective
3. CIt means the patient needs more lipid
4. DIt is a normal fasting value for adults

Why must a patient with a new coronary stent not stop their antiplatelet medicines without specialist advice?

1. AStopping early greatly increases the risk of a clot forming in the stent
2. BStopping causes severe low blood pressure
3. CStopping causes immediate kidney failure
4. DThe stent will dissolve if the drugs are stopped before the course ends

An older patient's blood pressure is 142/80 mmHg lying and 116/72 mmHg after standing for three minutes, and they feel dizzy. What does this show?

1. AWhite coat hypertension
2. BHypertensive emergency
3. CNormal blood pressure variation
4. DPostural hypotension

A patient takes both digoxin and furosemide. Why does the nurse watch the potassium level closely?

1. ALow potassium increases the risk of digoxin toxicity
2. BPotassium has no link with either medicine
3. CHigh potassium is the main effect of furosemide
4. DLow potassium makes digoxin stop working completely

Three days after an MI, a patient faints on the commode while straining hard to open the bowels. The heart rate was 42/min at the time. What is the most likely mechanism?

1. AA vagal response to straining
2. BAn allergic reaction to the commode
3. CA new pulmonary embolism
4. DLow blood glucose from fasting

Welke urinebevinding onderscheidt diabetes insipidus het best van SIADH?

1. ABij DI is de urine verdund; bij SIADH is de urine geconcentreerd
2. BBeide aandoeningen geven zeer geconcentreerde urine
3. CBij DI zit er glucose in de urine; bij SIADH eiwit
4. DBij DI is de urine geconcentreerd; bij SIADH is de urine verdund

The nurse has four urology patients. Which one needs to be seen first?

1. AA patient with a nephrostomy who has rigors and a BP of 86/50 mmHg
2. BA patient with stress incontinence asking about pelvic floor exercises
3. CA patient with a suprapubic catheter due for a routine change
4. DA patient after TURP with light pink drainage and mild discomfort

In welke periode na een operatie treedt wonddehiscentie het waarschijnlijkst op?

1. AMeer dan een jaar na de operatie
2. BOngeveer 5–10 dagen na de operatie
3. CBinnen het eerste uur
4. DAlleen tijdens de operatie

During preoperative assessment, a patient says their brother had a "very high fever" during an anaesthetic. What is the most important action?

1. AReassure the patient that fevers after anaesthesia are always harmless
2. BInform the anaesthetist, as malignant hyperthermia may run in the family
3. CRecord it as a family allergy to paracetamol
4. DGive paracetamol before surgery to prevent fever