Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

A drowsy patient who has just returned from surgery starts to vomit. What should the nurse do first?

1. ATurn the patient onto their side
2. BRaise the legs above the heart
3. CGive an oral anti-sickness tablet
4. DGive a drink of water

A patient with a head injury has a pupil on one side that is now large and does not react to light. What should the nurse do?

1. ADocument it, because pupils often differ slightly after a head injury
2. BDim the room lights so the pupil can get smaller
3. CRecheck it at the next routine observation in four hours
4. DReport it at once, as it may mean the brain is being compressed

A patient is on seizure precautions. Which equipment should be ready at the bedside?

1. AA tongue blade to put between the teeth
2. BWorking suction and oxygen equipment
3. CRestraints ready for all four limbs
4. DAn ice pack to place on the forehead

A nurse teaches new parents about safe infant sleep. Which statement shows a need for further teaching?

1. A“We will not smoke near the baby.”
2. B“We will keep the crib in our room, next to our bed, for the first months.”
3. C“We will put a soft bumper pad and a blanket in the crib so the baby is cozy.”
4. D“We will lay the baby on the back for every sleep, including naps.”

A patient with suspected pulmonary TB needs sputum samples for acid-fast bacilli. Which instruction is correct?

1. AGive one sample of saliva collected from the mouth at any time of day
2. BGive one sample after brushing with mouthwash so it is clean
3. CGive several deep-cough samples, often first thing in the morning
4. DGive several samples of nasal mucus blown into a tissue

A patient with blood pressure that is hard to control has a potassium of 2,9 mEq/L, a sodium of 144 mEq/L and a raised serum bicarbonate, without taking a diuretic. Which condition is most likely?

1. ASyndrome of inappropriate ADH
2. BPrimary adrenal insufficiency
3. CPrimary hyperaldosteronism
4. DCentral diabetes insipidus

Which drug is first-line in an acute asthma attack?

1. AA nebulised or inhaled short-acting beta₂-agonist (salbutamol/albuterol)
2. BAn oral antihistamine such as cetirizine taken every few hours
3. CAn oral beta-blocker
4. DA long-acting inhaled corticosteroid, used alone at a higher dose

Een patiënt met acute pancreatitis heeft hevige pijn in de bovenbuik die uitstraalt naar de rug. Welke verpleegkundige zorg is het belangrijkst?

1. AAlle vocht beperken
2. BStrikte bedrust zonder controles
3. CEen grote vette maaltijd om de alvleesklier te stimuleren
4. DAdequate pijnstilling, iv-vocht en nauwkeurige bewaking van de vochtbalans

During airway suctioning, when should suction be applied?

1. AOnly while withdrawing the catheter
2. BBefore the catheter enters the airway
3. CContinuously for at least 30 seconds
4. DOnly while inserting the catheter

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

Why should long-term steroid treatment not be stopped suddenly?

1. AThe suppressed adrenal glands cannot make enough cortisol at once
2. BStopping causes the blood glucose to fall sharply
3. CThe steroids build up and become toxic after they are stopped
4. DStopping suddenly makes the bones grow too quickly and then fracture

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

1. AA patient with a potassium of 6,8 mmol/L who reports palpitations
2. BA patient with mild itching from uraemia who wants a cream
3. CA patient with a creatinine slightly above their usual level
4. DA patient with CKD asking about their phosphate binder

Welke score wordt gebruikt om het risico bij een bloeding in het bovenste maag-darmkanaal vóór endoscopie te beoordelen?

1. AGlasgow-Blatchford-score
2. BWaterlow-score voor het risico op decubitus
3. CWells-score voor DVT
4. DGlasgow Coma Scale

Twee dagen na de start van chemotherapie voor een hooggradig lymfoom neemt de urineproductie van een patiënt af; het kalium is 6,4 mmol/L, fosfaat hoog en calcium laag. Waaraan moet de verpleegkundige denken en wat moet zij doen?

1. AEenvoudige uitdroging: orale vloeistoffen aanmoedigen en volgende week het bloed opnieuw controleren
2. BEen allergische reactie: een antihistaminicum geven en doorgaan zoals normaal
3. CVerwachte bijwerkingen van chemotherapie: geen actie nodig tot de volgende kuur
4. DTumorlysissyndroom: escaleren, hartbewaking starten en intraveneus vocht verwachten