Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

A patient with a head injury is being monitored. Which set of findings suggests rising intracranial pressure?

1. ARising systolic pressure, slow pulse and irregular breathing
2. BNormal blood pressure, normal pulse and clear speech
3. CLow temperature, fast breathing and a strong appetite
4. DFalling blood pressure, a fast pulse and warm, flushed dry skin

A patient has a wrist restraint. The nurse finds the fingers on that hand pale, cool and tingling. What should the nurse do first?

1. ATighten the restraint so the patient moves less
2. BRaise the arm on a pillow and check again in two hours
3. CLoosen the restraint and assess the circulation
4. DDocument the finding and continue with the medication round

Why are some patients screened with a nasal swab for MRSA on admission?

1. ATo diagnose a sinus infection
2. BTo check whether the patient is allergic to penicillin before surgery
3. CTo measure the patient’s immunity to MRSA
4. DTo find carriers so precautions or decolonization can be used

In START triage, a casualty cannot walk and is breathing 36 times a minute. Which category applies?

1. AYellow (delayed)
2. BRed (immediate)
3. CGreen (minor)
4. DBlack (expectant or dead)

A breathless patient in the emergency department has a BNP below 100 pg/mL. What does this suggest?

1. ASevere heart failure is certainly the cause of the problem
2. BHeart failure is an unlikely cause of the breathlessness
3. CThe kidneys are failing and the patient needs dialysis
4. DThe patient has had a myocardial infarction in the past day

Waarom kan een HbA1c-uitslag misleidend zijn bij een patiënt die twee weken geleden een grote bloedtransfusie kreeg?

1. AHbA1c is in elke situatie nauwkeurig
2. BTransfusies verhogen het HbA1c altijd tot vals hoge waarden
3. CVeel rode bloedcellen zijn donorcellen, die niet aan de glucose van de patiënt zijn blootgesteld
4. DHbA1c meet suiker op witte bloedcellen, niet op rode

Een patiënt met levercirrose wordt verward en suf, met een fladderende tremor van de handen. Welke complicatie is waarschijnlijk?

1. AAlleen alcoholintoxicatie
2. BHepatische encefalopathie
3. CBeroerte
4. DHypoglykemie door insuline

A patient with metastatic breast cancer is confused and constipated, with a corrected calcium of 3,3 mmol/L (about 13,2 mg/dL). What is usually the first treatment?

1. AIV fluid rehydration, followed by a bisphosphonate
2. BA high-calcium diet
3. COral calcium supplements and vitamin D
4. DStrict fluid restriction to protect the kidneys

Septic shock belongs to which category of shock?

1. AObstructive shock
2. BCardiogenic shock
3. CHypovolaemic shock
4. DDistributive shock

A ventilated patient is coughing, and the high-pressure alarm sounds. Coarse sounds are heard over the trachea. What should the nurse do first?

1. AIncrease the tidal volume on the ventilator to overcome it
2. BDeflate the endotracheal tube cuff fully
3. CTurn the alarm off and reassess the patient in an hour
4. DAssess the patient and suction if secretions are present

A man starts finasteride for an enlarged prostate. Which statement is correct?

1. AIt takes months to work; pregnant women must not handle broken tablets
2. BIt lowers the blood pressure, so dizziness is very common
3. CIt works within hours by relaxing the bladder muscle
4. DIt is used only for a few days at a time

A patient with a new arm fistula says their hand on that side is cold, pale and painful, especially during dialysis. What is the concern?

1. AAn allergic reaction to the dressing on the arm
2. BFluid overload in the arm
3. CNormal healing that needs no action
4. DSteal syndrome, which needs urgent review

Which nursing intervention best reduces preoperative anxiety?

1. ATelling the patient that there is nothing to worry about
2. BAvoiding talking about the operation at all
3. CExplaining what will happen and answering questions
4. DKeeping family members away until after surgery

A patient with active cancer on chemotherapy develops new swelling and pain in one calf. Why must this be reported promptly?

1. ACancer and its treatment greatly increase clot risk
2. BIt is only a muscle strain from walking
3. CThe swelling shows the cancer has gone
4. DCalf swelling is a normal effect of chemotherapy