Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

A patient’s urinary catheter has drained no urine for two hours, and the lower abdomen is swollen. What should the nurse do first?

1. ARemove the catheter and wait for the patient to void
2. BCheck the tubing for kinks or obstruction
3. CEncourage the patient to drink more water
4. DGive a prescribed diuretic straight away

A child with sickle cell disease in a pain crisis develops chest pain, fever and an SpO₂ of 89%. What does this most likely mean?

1. AAnxiety that will settle with reassurance
2. BA minor chest infection that can safely wait until the morning round
3. CAn ordinary pain crisis that will improve with rest
4. DAcute chest syndrome, which needs urgent escalation and oxygen

A patient with a fever and a cough arrives in a crowded clinic waiting room. What should the nurse do?

1. AGive everyone else in the waiting room a mask instead
2. BGive the patient a mask and seat them apart from others
3. CAsk the patient to wait outside in the car park
4. DDo nothing until the patient is seen by the provider

A nurse has worked three long shifts in a row and feels exhausted. The manager asks the nurse to stay for another shift. What is the most appropriate response?

1. AAgree without telling anyone about the fatigue
2. BAgree and drink extra coffee to stay alert
3. CAgree, but skip the independent medication checks to save energy on the shift
4. DExplain that fatigue would make care unsafe and decline the extra shift

A patient starts high-dose prednisone. Which laboratory change should the nurse expect?

1. AA rise in serum potassium
2. BA fall in the white cell count
3. CA fall in serum sodium
4. DA rise in blood glucose

A patient's AST is about twice the ALT, both moderately raised, and the GGT is high. Which cause is most likely?

1. AAcute myocardial infarction
2. BGallstone blocking the bile duct
3. CAcute viral hepatitis A
4. DAlcohol-related liver disease

Which advice is correct for a patient taking levothyroxine?

1. AStop taking it once the symptoms improve
2. BTake it on an empty stomach, usually before breakfast
3. CTake it with a large meal to avoid nausea and stomach upset
4. DTake it only on days when feeling tired

Het bloedonderzoek van een patiënt toont kalium 6,8 mmol/L en het ecg toont spitse T-toppen. Welke behandeling beschermt het hart het snelst?

1. AFurosemidetabletten de volgende dag
2. BAlleen een kaliumarm dieet
3. COrale kaliumsuppletie
4. DIv-calciumgluconaat

After a bronchoscopy with throat anaesthesia, when can the patient eat and drink?

1. AWhen the gag and cough reflexes have returned
2. BOnly after a chest X-ray has been reported
3. CAfter a full 24 hours without food
4. DImmediately after the scope is removed

De slang van de thoraxdrain van een patiënt raakt los van het drainagesysteem. Wat moet de verpleegkundige als eerste doen?

1. ADe slang enkele uren afklemmen en de patiënt later opnieuw controleren
2. BDe drain uit de borstkas verwijderen en de plek afdekken
3. CHem open aan de lucht laten tot de arts komt om te beoordelen
4. DHem opnieuw aansluiten, of het uiteinde van de slang in steriel water leggen, en dan beoordelen

An older patient with a long-term catheter has bacteria in the urine but no symptoms. What is usually appropriate?

1. AA full course of antibiotics straight away
2. BRemove the catheter permanently at once
3. CAntibiotics for life to keep the urine sterile
4. DNo antibiotics, as long as there are no symptoms

A patient with an external ventricular drain sat up in bed without help. The drain stayed at its old height, and the drainage bag filled quickly. The patient now has a headache. What is the concern?

1. AOverdrainage of CSF, so act per protocol and inform the team
2. BAn infected drain, so the dressing should be removed
3. CUnderdrainage, so the drain should be lowered further
4. DNo concern, because more drainage always lowers the ICP safely

Which description fits a category (stage) 4 pressure ulcer?

1. AIntact skin with redness that does not blanch
2. BA shallow wound into the dermis only
3. CA blister filled with clear fluid over the heel or sacrum
4. DFull-thickness loss with exposed bone, tendon or muscle

After signing the consent form, a patient tells the nurse, "I don't really understand what they are going to do." What should the nurse do?

1. AReassure the patient that the surgeon knows best
2. BIgnore the comment because the form is already signed
3. CInform the surgeon so that the procedure can be explained again
4. DExplain the surgical risks in detail without involving the surgeon