Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

A nurse teaches a patient about storing insulin at home. Which statement shows a need for further teaching?

1. A“I will keep unopened insulin in the fridge.”
2. B“I will not leave my insulin in a hot car.”
3. C“I will keep my spare insulin in the freezer so it lasts longer.”
4. D“I will check the expiry date on the label before I use the vial.”

A patient has peripheral arterial disease with a non-healing ulcer on the toe. Which advice about leg position is correct?

1. AWrap the legs tightly with compression bandages
2. BKeep the legs raised above the heart as much as possible
3. CSit with the legs crossed to improve blood flow
4. DKeep the legs level or slightly lowered, not raised

Welke handelwijze met materialen is juist bij een patiënt met contactisolatie?

1. ADezelfde stethoscoop bij alle patiënten gebruiken zonder te reinigen
2. BEen eigen stethoscoop en bloeddrukmanchet voor die patiënt gebruiken
3. CDe materialen van de patiënt meenemen naar de volgende kamer
4. DMaterialen uit de schone ruimte gebruiken en ze ongewijzigd terugzetten

During a power cut in a US hospital, a ventilator must stay powered. Where should it be plugged in?

1. AInto the outlet that is closest to the bed, whatever its color
2. BInto an extension cord from the corridor
3. CInto a red outlet connected to the emergency generator
4. DInto any white outlet in the room

Een patiënt heeft een hematocriet van 54%, een hoge BUN en een soortelijk gewicht van de urine van 1,034. Waar wijst dit patroon op?

1. AOvervulling
2. BUitdroging met hemoconcentratie
3. CAcuut bloedverlies met verdunning
4. DNierfalen met verdunde urine

A patient with acute pancreatitis has a rising BUN, a falling calcium and a glucose of 250 mg/dL (13,9 mmol/L) over the first 48 hours. What do these results suggest?

1. AAn unrelated new kidney stone
2. BA resolving, mild pancreatitis
3. CA lab error from lipemic samples
4. DIncreasingly severe pancreatitis

Why are people with diabetes advised to have regular eye screening?

1. ATo check whether they need reading glasses for close work
2. BTo measure their blood glucose through the eye
3. CTo detect diabetic retinopathy early, before sight is lost
4. DTo prevent conjunctivitis

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

A patient's blood pressure is high in clinic but normal on home readings. Which step best confirms the diagnosis?

1. AStarting two antihypertensive drugs at once at full dose
2. BA chest X-ray
3. CAmbulatory or structured home blood pressure monitoring
4. DA single repeat reading in the same clinic visit

A patient with obstructive sleep apnoea who uses CPAP at home is having surgery. Which plan is safest after the operation?

1. ANurse the patient lying flat on their back to keep the airway open
2. BGive extra opioids so the patient sleeps through the night
3. CUse their CPAP machine and monitor closely, using opioids with caution
4. DLeave the CPAP machine at home, as it is not needed while in hospital

For which patient with migraine would the nurse question an order for sumatriptan?

1. AA patient with a history of angina
2. BA patient who also has asthma
3. CA patient with well-controlled hypothyroidism
4. DA patient with an allergy to penicillin

A patient's glucose is 6,2 mmol/L (112 mg/dL) at 03:00 and 12 mmol/L (216 mg/dL) before breakfast. No hypoglycaemia occurred overnight. What is the most likely explanation?

1. AThe meter is faulty and should be replaced
2. BThe dawn phenomenon from early-morning hormones
3. CThe Somogyi effect from a night-time hypo
4. DA large snack eaten in the night by mistake

A day after a spinal anaesthetic, a patient has a headache that is worse when sitting up and better when lying flat. What is the most likely cause?

1. ARaised blood pressure from pain
2. BPost-dural puncture headache
3. CA side effect of the antibiotic
4. DMigraine caused by hospital lighting

A competent adult who is a Jehovah's Witness refuses blood transfusion before major surgery. What should the nurse do?

1. APlan to transfuse secretly during the operation if it becomes needed
2. BCancel the surgery without discussing it
3. CAsk the family to override the decision
4. DRespect the decision, document it and inform the team