Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

A patient coughs hard after abdominal surgery, and loops of bowel appear through the opened wound. What does the nurse do first?

1. ALeave the wound uncovered so the surgeon can see it on arrival
2. BHelp the patient walk to the toilet to relieve abdominal pressure
3. CPush the bowel gently back into the abdomen with a gloved hand
4. DCover the wound with sterile dressings moistened with saline

Two patients on the unit have the same surname. What should the nurse do before giving a medication?

1. AAsk the patient, “Are you Mr Smith?” and give the drug once he says yes
2. BAsk a nursing assistant which patient is which
3. CUse the room number as the main identifier
4. DCheck two identifiers against the wristband and the medication record

A portable x-ray is taken at the bedside. Which action protects the nurse?

1. AStand next to the patient and hold the film without protection
2. BStep away from the patient or wear a lead apron during the exposure
3. CStay close to the patient to keep them still without protection
4. DLook directly at the x-ray tube during the exposure to check its position

Welke handeling van een verpleegkundige laat zien dat de vijf momenten voor handhygiëne worden gevolgd?

1. AZij reinigt haar handen nadat zij het bedhek heeft aangeraakt
2. BZij reinigt haar handen alleen wanneer ze er vies uitzien
3. CZij reinigt haar handen alleen aan het begin en einde van de dienst
4. DZij draagt dezelfde handschoenen bij twee patiënten

Why is a blood β-hydroxybutyrate level often preferred to a urine ketone dipstick in DKA?

1. AIt shows the average ketone level over the past three months
2. BIt measures the main ketone in DKA, and the dipstick may miss it
3. CThe urine dipstick only detects ketones in people without diabetes
4. DIt is the only test that can measure glucose and ketones together

A patient has eaten very little for 2 weeks and has received broad-spectrum antibiotics. The INR is now 2,3 without warfarin, and the platelets are normal. What is the most likely cause?

1. AHemophilia A
2. BIron-deficiency anemia
3. CVitamin K deficiency
4. DImmune thrombocytopenia

Why is an ankle–brachial pressure index (ABPI) measured before applying compression bandages to a leg ulcer?

1. ATo measure how deep the ulcer is and how much exudate it produces
2. BTo work out the patient's fluid needs
3. CTo check for a urinary tract infection that could delay ulcer healing
4. DTo exclude significant arterial disease, as compression could cut off blood flow

Een patiënt met verdenking op meningitis heeft koorts, nekstijfheid en een niet-wegdrukbare huiduitslag. Wat heeft prioriteit?

1. AHet licht dimmen, rust aanmoedigen en de controles na vier uur herhalen
2. BParacetamol tegen de koorts geven en de patiënt morgen opnieuw beoordelen
3. COp de uitslag van de lumbaalpunctie wachten voordat enige behandeling start
4. DDringende beoordeling en direct antibiotica, zonder op onderzoeken te wachten

Septic shock belongs to which category of shock?

1. AObstructive shock
2. BCardiogenic shock
3. CDistributive shock
4. DHypovolaemic shock

A patient with a COPD exacerbation has been on NIV for two hours. They are now more drowsy, and the pH has fallen further despite a good mask fit. What should the nurse do?

1. ARemove the mask and give nebulised bronchodilators only from now on
2. BContinue NIV unchanged and repeat the blood gas tomorrow morning
3. CGive a sedative to help the patient tolerate the mask
4. DEscalate urgently for review of intubation or a ceiling of care

In the first trimester of pregnancy, why is propylthiouracil often preferred to carbimazole for hyperthyroidism?

1. APropylthiouracil works faster than any other drug
2. BPropylthiouracil has no side effects at all
3. CCarbimazole has a higher risk of birth defects early on
4. DCarbimazole cannot cross into the mother's blood

A patient's potassium is 7,1 mmol/L, and the ECG shows peaked T waves and broad QRS complexes. What is the first treatment?

1. AIV furosemide
2. BOral sodium bicarbonate
3. COral potassium binder
4. DIV calcium gluconate

Which liver function test pattern suggests bile duct obstruction?

1. ANormal bilirubin with a low ALP and low GGT
2. BHigh bilirubin with a markedly raised ALP and GGT
3. CA low albumin with all other results normal
4. DVery high ALT with a normal bilirubin only

After surgery, a patient says they have "no pain" but grimaces, breathes shallowly and refuses to move or cough. What should the nurse do?

1. AAccept the statement and record a pain score of 0
2. BTell the patient firmly that they must stop hiding their pain from staff
3. CExplore their beliefs and explain how analgesia aids recovery
4. DInsist they walk without any analgesia