Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

Een verpleegkundige krijgt vier oproepen tegelijk. Naar welke patiënt gaat de verpleegkundige als eerste?

1. AEen patiënt van wie de infuuspomp alarmeert omdat een zak onderhoudsvloeistof leeg is
2. BEen patiënt die zegt: "Ik krijg geen adem."
3. CEen patiënt die om pijnstilling vraagt voor pijn van 4/10
4. DEen patiënt die vraagt hoe laat de dokter komt

A patient with a head injury has a pupil on one side that is now large and does not react to light. What should the nurse do?

1. ADocument it, because pupils often differ slightly after a head injury
2. BDim the room lights so the pupil can get smaller
3. CRecheck it at the next routine observation in four hours
4. DReport it at once, as it may mean the brain is being compressed

Which measure is part of the bundle for inserting a central venous catheter to prevent bloodstream infection?

1. ARoutine replacement of the catheter on a fixed schedule, such as every three days
2. BChlorhexidine-alcohol skin antisepsis and maximal sterile barrier precautions
3. CChoosing the femoral vein as the first site in adults
4. DGiving antibiotics to every patient before insertion

Een handgeschreven voorschrift luidt “10U gewone insuline subcutaan nu”. Wat is de beste handelwijze van de verpleegkundige?

1. A10 eenheden geven zonder vragen, zoals geschreven
2. B100 eenheden geven, zoals het voorschrift lijkt te zeggen
3. CHet voorschrift verduidelijken, omdat “U” verkeerd gelezen kan worden
4. DEen zorgassistent vragen het handschrift te interpreteren

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

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

A patient receiving IV magnesium sulfate has a respiratory rate of 9/min and absent patellar reflexes. After stopping the infusion, which medication should the nurse expect to give?

1. APotassium chloride
2. BProtamine sulfate
3. CSodium bicarbonate
4. DCalcium gluconate

Which group of symptoms suggests hypothyroidism?

1. ATiredness, weight gain and feeling cold
2. BExcessive thirst and passing large volumes of urine
3. CFever, neck stiffness and photophobia
4. DWeight loss, heat intolerance and tremor

Which feature best distinguishes delirium from dementia?

1. ADelirium starts suddenly and fluctuates, while dementia develops gradually
2. BDementia always causes visual hallucinations
3. CDelirium only affects people under 50, while dementia affects older people
4. DDelirium is permanent, while dementia is reversible

A patient with diabetes is starting a beta-blocker. What should the nurse teach about hypoglycaemia?

1. AThe beta-blocker will prevent all episodes of hypoglycaemia
2. BHypoglycaemia will always cause a very slow and weak pulse
3. CInsulin should be stopped while taking a beta-blocker
4. DSome warning signs, such as a fast heartbeat, may be masked

A nurse looked after a patient for a shift before smear-positive pulmonary TB was diagnosed, without wearing a respirator. What should happen?

1. AStart a full six-month course of TB drugs at once without any tests
2. BStay off work for six months in case symptoms develop
3. CTake no action, as healthcare workers are immune to TB
4. DReport it so occupational health can arrange follow-up screening

After transsphenoidal pituitary surgery, which advice should the patient follow?

1. ALie completely flat for at least a week after surgery
2. BDrink through a straw to keep the nose clean
3. CBlow the nose often to clear any clots
4. DAvoid blowing the nose, straining and bending forward

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

Which practice is correct when giving parenteral nutrition through a central line?

1. AUse a dedicated lumen and strict aseptic technique
2. BDisconnect and reconnect the line without cleaning the hub
3. CGive other IV drugs through the same lumen to save time
4. DLet the bag hang at room temperature for several days

During a nerve block, a patient reports a metallic taste and ringing in the ears, then has a seizure. Besides calling for help and supporting the airway, which specific treatment is given?

1. AIV dantrolene
2. BIV naloxone
3. CIV glucose 50%
4. DIV lipid emulsion