Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

A patient taking lisinopril develops swelling of the lips and tongue. What should the nurse do first?

1. ATell the patient this is a common, harmless effect
2. BApply a cold pack and recheck in an hour
3. CGive the next dose of lisinopril with water
4. DAssess the airway and call for urgent help

A nurse teaches a patient to inject enoxaparin at home. Which statement shows a need for further teaching?

1. A“I will rub the area after the injection to help it absorb.”
2. B“I will tell my doctor if I notice unusual bruising or bleeding.”
3. C“I will inject into the fat of my abdomen, away from the navel.”
4. D“I will change the injection site each time.”

Why does a nurse wear chemotherapy-tested gloves and a gown when emptying the urinal of a patient who recently had chemotherapy?

1. AThe urine always contains infectious bacteria after chemotherapy
2. BThe body fluids can contain active drug for a time after treatment
3. CChemotherapy makes the urine strongly acidic and corrosive
4. DThe patient is on airborne precautions after treatment

Een verpleegkundige merkt dat het verkeerde geneesmiddel is opgetrokken, maar beseft dat voordat het wordt gegeven. Wat moet de verpleegkundige doen?

1. AHet geneesmiddel toch geven, omdat het al is opgetrokken
2. BHet alleen melden als dezelfde fout opnieuw op de afdeling gebeurt
3. CHet weggooien, het juiste geneesmiddel klaarmaken en een bijna-incident melden
4. DNiets zeggen, omdat de patiënt geen schade heeft opgelopen

A patient with central diabetes insipidus starts desmopressin. Which laboratory result is most important to monitor for an adverse effect?

1. ASerum glucose, which may rise very high
2. BSerum sodium, which may fall too low
3. CSerum calcium, which may rise too high
4. DSerum potassium, which may rise too high

A young adult has fatigue, bruising and fever. The white cell count is 85 × 10³/µL with many blasts, the hemoglobin is 7,9 g/dL (79 g/L) and the platelets are 22 × 10³/µL. What is the most likely diagnosis?

1. AAcute viral infection
2. BAcute leukemia
3. CIron-deficiency anemia
4. DPolycythemia vera

Which mask is required for staff during an aerosol-generating procedure on a patient with a respiratory infection spread by aerosols?

1. AA cloth face covering
2. BA fit-tested respirator mask (such as FFP3 or N95)
3. CNo mask, as long as gloves are worn
4. DA standard fluid-repellent surgical mask with a visor

A patient with diabetes is found confused with slurred speech and weakness on one side. What should the nurse check first?

1. ACapillary blood glucose
2. BSerum cholesterol
3. CUrine output for the last day
4. DBody mass index

Wat is de ejectiefractie?

1. AHet volume bloed dat het hart elke minuut rondpompt
2. BDe druk in de linkerkamer aan het einde van de diastolische vulling
3. CHet volume bloed dat bij elke hartslag wordt uitgepompt
4. DHet percentage bloed in de ventrikel dat bij elke hartslag wordt uitgeworpen

A heavy smoker is having surgery tomorrow and asks whether stopping smoking now is pointless. Which reply is most accurate?

1. AStopping even today lowers carbon monoxide levels before surgery
2. BIt is pointless unless they stopped smoking at least a year ago
3. CStopping now will make the operation more dangerous
4. DSmoking before surgery protects the lungs from the anaesthetic gases

Which statement about giving IV potassium is correct?

1. AIt can be given quickly as a push to correct the level fast
2. BIt is safest given through a small vein in the hand at a fast rate
3. CIt is diluted and given through an infusion pump, never as a bolus
4. DIt needs no monitoring at all once the infusion is running

Een patiënt heeft episodes van ernstige hoofdpijn, zweten, hartkloppingen en zeer hoge bloeddruk. Aan welke aandoening moet worden gedacht?

1. AFeochromocytoom
2. BZiekte van Addison
3. CDiabetes insipidus
4. DHypothyreoïdie

Which technique is correct when giving a prefilled low molecular weight heparin injection?

1. AInject into a vein in the back of the hand
2. BRub the site firmly afterwards to help absorption
3. CLeave the air bubble in and inject into a skin fold
4. DExpel the air bubble first and inject into the deltoid muscle

On the morning of elective hip surgery, a patient says she took her usual warfarin last night despite being told to stop. What should the nurse do?

1. ATell her the surgery must be cancelled for a month
2. BProceed with the usual checklist and say nothing
3. CGive a double dose of vitamin K by mouth without waiting for a prescription
4. DInform the surgical and anaesthetic teams, who will check the INR