Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

On a postpartum unit, which patient is the most appropriate to assign to an LPN/LVN?

1. ASevere pre-eclampsia on a magnesium sulfate infusion
2. BDay 1 after an uncomplicated vaginal birth, stable vital signs
3. CA new admission transferred from the labor ward with a fever of 38,6 °C
4. DOne hour after birth with heavy bleeding and a boggy uterus

Welke postoperatieve patiënt moet de verpleegkundige op een chirurgische afdeling als eerste zien?

1. A2 dagen na een heupvervanging: pijn 5/10 bij bewegen, pijnstilling 1 uur geleden gegeven
2. B2 dagen na het aanleggen van een colostoma: stoma vochtig en roze, kleine hoeveelheid output
3. C6 uur na een carotisendarteriëctomie: toenemende zwelling van de hals, zegt dat slikken moeilijk is
4. DNa prostaatoperatie met blaasspoeling: lichtroze urine, geen stolsels

Een verpleegkundige krijgt telefonisch een mondeling voorschrift. Wat is de veiligste handelwijze?

1. AHet uitvoeren zonder het vast te leggen
2. BHet opschrijven en terugvragen aan de voorschrijver (read-back)
3. CEen collega vragen mee te luisteren en het ook te onthouden
4. DHet onthouden en aan het einde van de dienst opschrijven

A competent adult patient with pneumonia wants to leave the hospital against medical advice. What should the nurse do?

1. AApply wrist restraints until the provider arrives to speak with the patient
2. BExplain the risks, notify the provider and follow the policy for leaving against advice
3. CLock the doors so the patient cannot leave
4. DHide the patient’s clothes and belongings so that they cannot leave the ward

A patient on warfarin has an INR of 7,8 and a nosebleed. Which medication would the nurse expect the provider to prescribe?

1. AProtamine sulfate
2. BVitamin K (phytonadione)
3. CNaloxone hydrochloride
4. DAcetylcysteine

Two days after bowel surgery, a patient with nasogastric suction has a distended abdomen, absent bowel sounds and muscle weakness. The potassium is 2,8 mEq/L. Which interpretation is best?

1. AHypokalemia from gastric losses is contributing to paralytic ileus
2. BHyperkalemia from tissue damage is causing the bowel to stop
3. CThe potassium is normal for the second day after surgery
4. DThe low potassium is due to the patient drinking too much water

Why is an urgent brain scan needed before thrombolysis for a suspected stroke?

1. ATo confirm the patient's age
2. BTo rule out bleeding in the brain
3. CTo measure the size of the ventricles
4. DTo check for brain tumours only

A patient has a painful, punched-out ulcer on the toes, with a cold, pale foot and weak foot pulses. Which type of ulcer is most likely?

1. AA pressure ulcer from bed rest
2. BAn arterial ulcer
3. CA venous ulcer
4. DA burn

Which investigation is usually used to confirm a deep vein thrombosis in the leg?

1. AAn exercise ECG
2. BA plain chest X-ray and an ECG
3. CCompression duplex ultrasound
4. DA lung function test

Which task for a stable patient with heart failure can the registered nurse most appropriately delegate to a healthcare assistant (unlicensed assistive personnel)?

1. AAssessing lung sounds for new crackles
2. BDeciding whether to give the furosemide dose
3. CTeaching the patient about a low-salt diet
4. DMeasuring and recording the morning weight

Why is pyridostigmine often taken about 30–60 minutes before meals by patients with myasthenia gravis?

1. ATo stop the drug from irritating an empty stomach later on
2. BTo improve the strength of chewing and swallowing at mealtimes
3. CTo lower the blood glucose rise after eating a meal
4. DTo reduce stomach acid so the food is digested better

A nurse teaches the family of a patient on insulin how to manage a severe hypo. Which statement shows a need for further teaching?

1. A"If she is unconscious, I will pour juice into her mouth."
2. B"I will put her on her side and call an ambulance straight away."
3. C"I will give the glucagon as I was shown."
4. D"When she can swallow, I will give her a snack."

Een patiënt met een acute bloeding in het bovenste maag-darmkanaal heeft bij aankomst een normaal hemoglobine. Waarom kan dit misleidend zijn?

1. AHemoglobine stijgt altijd eerst na elk bloedverlies
2. BHet daalt pas nadat vochtverschuivingen of intraveneus vocht het bloed verdunnen
3. CHemoglobine wordt niet beïnvloed door bloedingen uit de darm
4. DHemoglobine daalt pas na een hele week van continue bloeding

During a nasogastric feed, a patient starts coughing and SpO₂ falls from 96% to 89%. What should the nurse do first?

1. AStop the feed and assess the airway and breathing
2. BIncrease the feed rate to finish it sooner
3. CGive a drink of water to clear the throat
4. DLay the patient flat to help them rest