Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

A nurse teaches a patient with COPD pursed-lip breathing. Which statement shows a need for further teaching?

1. A“I will breathe in through my mouth and out quickly through my nose.”
2. B“I will breathe in slowly through my nose.”
3. C“I will breathe out slowly through pursed lips.”
4. D“I will make my breath out about twice as long as my breath in.”

Een patiënt met een bloeding in het bovenste maag-darmkanaal heeft een hartfrequentie van 128/min en een bloeddruk van 84/50 mmHg. Dit alles is voorgeschreven. Welke start de verpleegkundige als eerste?

1. ADe diagnostische endoscopie voor de volgende ochtend boeken
2. BOrale ijzertabletten
3. CIntraveneuze vloeistof of bloed via dikke canules
4. DEen intraveneuze protonpompremmer-infusie

A nurse’s hands are dry and cracked from frequent hand hygiene. What is the best approach?

1. AUse any lotion from home, whatever its contents
2. BUse the hand lotion approved by the facility to keep the skin intact
3. CStop hand hygiene until the skin heals
4. DWear gloves all day instead of cleaning the hands between patients

Een kind met waterpokken wordt opgenomen. Welke medewerker is de beste keuze om het kind te verzorgen?

1. AEen student-verpleegkundige met onbekende immuniteit
2. BEen verpleegkundige die nooit waterpokken heeft gehad of is gevaccineerd
3. CEen verpleegkundige met aangetoonde immuniteit voor varicella
4. DEen verpleegkundige die zwanger is en niet zeker is van haar immuniteit

A patient with hyperkalemia is prescribed an oral potassium binder such as patiromer or sodium zirconium cyclosilicate. How does this drug lower potassium?

1. AIt binds potassium in the gut so it leaves in the stool
2. BIt protects the heart muscle against high potassium levels
3. CIt stops the kidneys from absorbing water in the tubules
4. DIt moves potassium into cells in the next few minutes

A patient with ongoing hemolytic anemia has an HbA1c of 4,6%, but home glucose readings are often 180–220 mg/dL (10–12 mmol/L). What best explains the gap?

1. AHemolysis makes the HbA1c test read too high
2. BShort red cell life span lowers the HbA1c falsely
3. CThe patient has true, well-controlled diabetes
4. DThe home glucose meter is reading falsely high

Modern wound care generally aims to keep a healing wound bed:

1. ATightly packed with dry gauze
2. BMoist but not wet
3. CCompletely dry and open to the air
4. DSoaked in antiseptic solution every day

A patient with several days of vomiting and diarrhoea has low blood pressure, low urine output and a rising creatinine. Which description fits best?

1. APost-renal acute kidney injury from obstruction, treated with a catheter
2. BIntrinsic kidney injury from glomerulonephritis, treated with high-dose steroids
3. CChronic kidney disease, treated with long-term dialysis three times a week
4. DPre-renal acute kidney injury from poor perfusion, treated by restoring fluid volume

The telemetry monitor suddenly shows a chaotic waveform resembling ventricular fibrillation, but the patient is talking and brushing their teeth. What should the nurse do first?

1. ACheck the patient and the electrodes, as this is likely artefact
2. BGive IV amiodarone as a bolus
3. CStart chest compressions straight away and call the arrest team
4. DDeliver an immediate defibrillation shock before checking anything

An older ex-smoker has a dry cough and worsening breathlessness over a year, finger clubbing and fine "Velcro-like" crackles at both bases at the end of inspiration. Which condition is most likely?

1. ACommunity-acquired pneumonia
2. BSpontaneous pneumothorax
3. CIdiopathic pulmonary fibrosis
4. DAn acute asthma attack

Wat is de meest voorkomende uitlokker van autonome dysreflexie bij een patiënt met een dwarslaesie?

1. AEen grote maaltijd die 's nachts te snel wordt gegeten
2. BEen lange periode van slaap
3. CEen lage bloedglucose
4. DEen volle blaas of verstopte katheter

A day after a total thyroidectomy, a patient has tingling lips, a positive Chvostek's sign and a corrected calcium of 1,85 mmol/L (about 7,4 mg/dL). What does the nurse expect?

1. AOral levothyroxine, with a recheck of the calcium in a month
2. BA loop diuretic to remove the extra calcium
3. CIV calcium gluconate and monitoring for laryngospasm
4. DIV potassium chloride and a fluid restriction

Why should antacids usually be taken at a different time from other medicines?

1. AThey destroy other drugs before they are swallowed
2. BThey make all other drugs much more toxic
3. CThey stop the kidneys from clearing other drugs
4. DThey can reduce the absorption of many other drugs

Een patiënt met hepatische encefalopathie is 's nachts onrustig. Er wordt een benzodiazepine voor de slaap voorgesteld. Wat moet de verpleegkundige doen?

1. AHet geven, omdat de lever geen invloed heeft op sedativa
2. BHet geven en de lactulose stoppen om diarree te voorkomen
3. CHet in dubbele dosis geven om te zorgen dat de patiënt slaapt
4. DHet in twijfel trekken, omdat sedativa de encefalopathie kunnen verergeren