Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

A parent calls to say their toddler has just swallowed drain cleaner. What should the nurse advise?

1. AWait to see whether the child develops any symptoms first
2. BGive a large glass of fizzy drink or milk to dilute the cleaner before calling anyone
3. CDo not make the child vomit; call poison control or emergency services now
4. DMake the child vomit straight away to bring up the chemical

A nurse returns to the station to find four messages. Which one is answered first?

1. AA family member wants an update on their father’s progress
2. BA colleague asks to swap shifts with them next week because of a family wedding
3. CThe laboratory is calling with a critical potassium result of 2,6 mEq/L
4. DThe pharmacy asks when the next delivery should be scheduled

A nurse wants to set up a sterile field in the morning for a procedure that will take place after lunch. What is correct?

1. ASet it up in the morning and ask a colleague to check it once
2. BSet it up in the morning and cover it with a clean towel until the procedure starts
3. CSet it up in the morning and leave it uncovered in an empty room
4. DSet it up just before the procedure, because a waiting field may become contaminated

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. BPunch the patient back in self-defense
3. CGet medical assessment and report the assault according to policy
4. DRefuse to care for any patient for the rest of the week until the patient is moved

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

Four results arrive at the same time. Which patient should the nurse see first?

1. AHemoglobin 10,4 g/dL (104 g/L) in a patient with stable chronic kidney disease
2. BGlucose 48 mg/dL (2,7 mmol/L) in a patient who had insulin an hour ago
3. CWhite cell count 12,0 × 10³/µL on the first day after surgery
4. DINR 2,6 in a patient on warfarin for atrial fibrillation

What is the most common cause of hypernatraemia in frail older inpatients?

1. AEating too much salt in one meal
2. BTaking too many vitamins
3. CToo much exercise
4. DNot drinking enough water

A patient with a central venous catheter develops fever and rigors shortly after the line is flushed, with no other obvious source. What should be suspected?

1. ANormal response to line use
2. BA catheter-related bloodstream infection
3. CA pulmonary embolism
4. DAn allergic reaction to the saline flush

Wanneer moet volgens de huidige richtlijnen zuurstof worden gegeven aan een patiënt met een acuut coronair syndroom?

1. AAltijd met 15 L/min, ongeacht de saturatie
2. BNooit, omdat zuurstof de hartspier beschadigt
3. CAlleen wanneer de SpO₂ onder het streefgebied ligt
4. DPas wanneer de troponine-uitslag beschikbaar is

As the defibrillator charges, a nurse sees a colleague still holding the patient's bed rail. What should the nurse do?

1. ATurn off the defibrillator and start a new cycle of CPR
2. BDeliver the shock now, as the bed rail is not part of the patient
3. CAsk the colleague to hold the patient's hand instead
4. DCall clearly for everyone to stand clear and check before the shock

Een patiënt met een beroerte in de rechterhemisfeer negeert het eten aan de linkerkant van het bord. Hoe heet dit?

1. AExpressieve afasie
2. BDysfagie
3. CLinkszijdig neglect
4. DCerebellaire ataxie

A patient with diabetic neuropathy has a hot, red, swollen foot that is barely painful. The skin is intact, and there is no fever. What should the nurse suspect?

1. AGout, which only needs pain relief
2. BA sprained ankle that will settle with walking
3. CAn acute Charcot foot, needing urgent offloading
4. DNormal swelling from standing too long

After a spinal anaesthetic, which nursing check is particularly important?

1. ABlood glucose every 15 minutes overnight
2. BPeak flow before and after each meal
3. CPupil reaction every five minutes for the next full day
4. DReturn of leg sensation and movement, and passing urine

A patient with advanced cancer who has capacity decides to stop chemotherapy. The family insists that treatment must continue. What should the nurse do?

1. AAsk the family to sign a new consent form
2. BTell the patient that stopping is not allowed
3. CSupport the patient's decision and help the team talk with the family
4. DContinue treatment because the family has asked for it