Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

A nurse has given rapid-acting insulin, and then learns that the patient’s meal tray will be 45 minutes late. What should the nurse do?

1. ATell the patient to wait and do nothing until the tray comes
2. BGet the patient some carbohydrate food now and check the glucose
3. CGive a second, smaller dose of insulin when the meal tray finally arrives
4. DAsk the patient to walk around the ward until the food arrives

An infant with pyloric stenosis has repeated projectile vomiting. Which acid-base imbalance is most likely?

1. AMetabolic alkalosis
2. BRespiratory alkalosis
3. CRespiratory acidosis
4. DMetabolic acidosis

A colleague has drawn up a medication and asks the nurse to give it to her patient. What should the nurse do?

1. AGive it, and document that the colleague prepared it
2. BGive it, because the colleague is experienced
3. CDecline, and give only medications that the nurse prepared or checked personally
4. DGive it, as long as the syringe has a label with the drug name on it

Een verwarde patiënt met polsfixatie heeft koele, bleke vingers aan één hand en een zwakke pols van de arteria radialis aan die kant. Wat moet de verpleegkundige als eerste doen?

1. ADe bevindingen zorgvuldig vastleggen en over twee uur opnieuw controleren
2. BDe hand op een kussen leggen en de fixatie laten zoals die is
3. CDe andere fixatie aantrekken om te voorkomen dat de patiënt eraan trekt
4. DDie fixatie losser maken en de doorbloeding van de hand beoordelen

Two sets of blood cultures are ordered for a patient with suspected sepsis. How are they best collected?

1. AFrom the existing IV line while the infusion continues to run
2. BFrom two separate venipuncture sites, using strict aseptic technique
3. CBoth from the same site, one minute apart, to save time for the patient
4. DAfter the first antibiotic dose, so the infusion is not delayed

A young woman with frequent self-induced vomiting has swollen salivary glands. Which laboratory pattern is most likely?

1. ALow potassium, high bicarbonate and high amylase
2. BHigh potassium, low bicarbonate and low amylase
3. CHigh calcium, high phosphate and high glucose
4. DLow sodium, low bicarbonate and high lipase

Which pattern is typical of relapsing–remitting multiple sclerosis?

1. AAttacks of symptoms, such as visual loss or numbness, that improve between relapses
2. BA single stroke that leaves permanent weakness
3. CSudden severe headache with neck stiffness
4. DConstant weakness that starts in the feet and spreads upwards after a viral illness

Een patiënt heeft al drie dagen diarree en ligt op een interne afdeling. Wat is de meest passende infectiepreventiemaatregel?

1. ADirect isoleren, contactisolatie toepassen en een feceskweek insturen
2. BDe patiënt naar een meerpersoonskamer verplaatsen zodat eenpersoonskamers vrij blijven
3. CAlleen handalcohol gebruiken en handschoenen vermijden om middelen te sparen
4. DWachten tot de diarree een week duurt voordat je iets doet

Where is the V1 electrode placed for a 12-lead ECG?

1. AOver the left nipple
2. BThe fifth intercostal space in the mid-axillary line
3. CJust below the left collarbone
4. DThe fourth intercostal space just right of the sternum

Een patiënt die dabigatran gebruikt, heeft een ernstige maagdarmbloeding. Welk specifiek antidotum kan worden gebruikt?

1. AIdarucizumab
2. BProtaminesulfaat
3. CTranexaminezuur alleen
4. DFytomenadion (vitamine K)

A patient takes levodopa for Parkinson's disease. Which teaching point is correct?

1. AThe drug cures the disease if taken for a full year
2. BLarge high-protein meals can reduce how well the drug works
3. CStop the drug for a day each week to avoid tolerance
4. DThe tablets work best taken with a large steak dinner

A man with chronic urinary retention is catheterised. Over the next hours he passes very large volumes of urine. What is the main nursing concern?

1. AA urinary infection caused by the high flow of urine
2. BFluid and electrolyte loss from post-obstructive diuresis
3. CA rise in blood glucose from the urine
4. DRupture of the bladder from the catheter

Which advice has good evidence for reducing cancer-related fatigue?

1. AComplete bed rest for the whole course of treatment
2. BDrinking several strong coffees every evening
3. CAvoiding all daily activities
4. DRegular light to moderate activity, such as walking

Which medicine commonly needs enteral feeds paused before and after each dose because the feed reduces its absorption?

1. APhenytoin
2. BLactulose
3. CParacetamol
4. DOmeprazole liquid