Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

Welke instructie aan een zorgassistent is het duidelijkst?

1. A"Laat het me weten als er iets mis lijkt met meneer Lee terwijl je bij hem bent."
2. B"Meet om 10:00 uur de bloeddruk van meneer Lee en meld het me meteen als de systolische druk onder 100 is."
3. C"Doe de vitale functies van meneer Lee ergens vóór de lunch en schrijf ze voor me in het dossier."
4. D"Houd meneer Lee vanochtend in de gaten en laat me weten hoe het met hem gaat."

Welke patiënt moet op een spoedeisende hulpafdeling direct naar een behandelkamer?

1. AEen 45-jarige die om een herhaalrecept vraagt
2. BEen 25-jarige met een verstuikte pols en normale vitale functies
3. CEen 60-jarige met drukkend gevoel op de borst, zweten en misselijkheid gedurende 20 minuten
4. DEen 30-jarige met keelpijn sinds twee dagen en een temperatuur van 38,0 °C

A patient has received oral radioactive iodine therapy. Which precaution is usually taken?

1. APlace the patient on droplet precautions with a surgical mask
2. BLet the patient share a bathroom with other patients
3. CEncourage pregnant visitors to sit close to the patient to give emotional support
4. DLimit time close to the patient and handle body fluids per radiation policy

A patient sitting in a chair starts to have a generalized seizure. What should the nurse do?

1. APut a padded tongue blade between the teeth to protect the tongue and airway
2. BHold the patient firmly in the chair until the seizure stops
3. CEase the patient to the floor, protect the head and turn them on their side
4. DLeave to get the provider, then return

A patient on warfarin has an INR of 7,8 and a nosebleed. Which medication would the nurse expect the provider to prescribe?

1. ANaloxone hydrochloride
2. BVitamin K (phytonadione)
3. CProtamine sulfate
4. DAcetylcysteine

Na een operatie krijgt een patiënt die grote volumes hypotone infuusvloeistof krijgt hoofdpijn, misselijkheid en verwardheid. Welke uitslag verklaart dit het best?

1. AEen kalium van 4,2 mEq/L
2. BEen natrium van 126 mEq/L
3. CEen calcium van 9,4 mg/dL (2,35 mmol/L)
4. DEen glucose van 110 mg/dL (6,1 mmol/L)

Which advice is correct for a patient taking levothyroxine?

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

Which feature best distinguishes delirium from dementia?

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

A patient who had a stroke has a weak swallow. Which measure most reduces the risk of aspiration pneumonia?

1. AGiving meals while the patient is drowsy
2. BGiving thin fluids quickly through a straw between meals
3. CLying flat for 30 minutes after eating to aid digestion
4. DA swallowing assessment and sitting upright for meals

A patient with severe aortic stenosis is prescribed glyceryl trinitrate (nitroglycerin) for chest pain. Why should the nurse use particular caution?

1. AGTN raises the blood pressure dangerously in aortic stenosis
2. BThere is no reason for caution, because GTN acts only on the coronary arteries
3. CGTN makes the narrowed aortic valve tighten further within a few minutes
4. DVasodilators can cause a severe fall in BP with a fixed outflow obstruction

Which approach helps most when talking to a patient with expressive aphasia?

1. ASpeak louder, because the patient cannot hear well
2. BFinish their sentences quickly to save them effort
3. CAvoid talking to them until their speech has recovered
4. DAsk questions that can be answered with yes, no or a gesture

A patient on haemodialysis is on a medical ward. Which task can the registered nurse delegate to a healthcare assistant (nursing assistant)?

1. ATeaching the patient about fluid restriction
2. BWeighing the patient before they go to dialysis
3. CAssessing the thrill and bruit of the fistula
4. DDeciding which morning medicines to hold

A patient has taken oral prednisolone daily for many months. Why is this important before surgery?

1. AThey may need extra steroid cover to prevent an adrenal crisis
2. BSteroids must always be stopped a full week before any type of surgery
3. CSteroids prevent all wound infections after surgery
4. DSteroids make the anaesthetic drugs last much longer

On day 5 after bowel resection, a patient has a fever, tachycardia and worsening abdominal pain, and the drain contains brown, faeculent fluid. What is most likely?

1. AA urinary tract infection
2. BAn anastomotic leak
3. CA normal day 5 recovery
4. DPostoperative constipation