Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

Two hours after birth, the nurse finds the uterus firm but above the umbilicus and pushed to the right. What should the nurse do first?

1. AHelp the patient empty her bladder
2. BMassage the uterus firmly for ten minutes
3. CGive a dose of oxytocin straight away
4. DAsk the patient to lie still for another hour

A patient with COPD on 2 L/min oxygen becomes drowsy and hard to wake. The SpO₂ is 93%. What is the priority?

1. AAssess breathing and escalate for a blood gas, as carbon dioxide may be rising
2. BLet the patient sleep, because the saturation is above target
3. CIncrease the oxygen to 6 L/min so that the saturation goes even higher than now
4. DGive the as-needed sedative so the patient rests comfortably

Een patiënt met vermoedelijke tuberculose ligt in een kamer met onderdruk. Welke handelwijze is juist?

1. ADe ventilatie van de kamer 's nachts uitzetten
2. BDe deur gesloten houden, behalve bij het binnengaan of verlaten van de kamer
3. CBezoekers zonder enige bescherming binnen laten
4. DDe deur open houden zodat het personeel de patiënt altijd kan zien

During bedside handoff, the patient says, “I’m allergic to sulfa drugs,” but no allergy is recorded. What should the nurse do?

1. ATell the patient that sulfa drugs are always safe
2. BIgnore it, because the electronic record is more reliable than the patient’s memory
3. CClarify the reaction, update the allergy record and tell the prescriber
4. DWait until the patient is discharged to update the record

Which blood collection practice helps prevent hemolysis of the sample?

1. AUsing the smallest needle available for every patient
2. BLeaving the tourniquet on for at least 3 minutes
3. CForcing blood quickly through a needle into the tube
4. DGently inverting the tubes instead of shaking them

A patient has taken metformin for 8 years and now has numbness in the feet, a hemoglobin of 10,2 g/dL (102 g/L) and an MCV of 108 fL. Which deficiency is most likely?

1. AIron deficiency from gut loss
2. BVitamin K deficiency
3. CVitamin D (calciferol) deficiency
4. DVitamin B₁₂ deficiency

A patient says they are "allergic" to codeine because it made them constipated. How should this be recorded?

1. AAs an allergy to all painkillers
2. BIt should not be recorded at all
3. CAs a severe anaphylactic allergy to all opioids
4. DAs a side effect or intolerance, not a true allergy

A patient with severe ulcerative colitis develops abdominal distension, fever and tachycardia, and the number of stools falls. What complication should be suspected?

1. ACoeliac disease
2. BRecovery from the colitis
3. CConstipation from dehydration
4. DToxic megacolon

Waarom mag een eenvoudig gezichtsmasker niet worden gebruikt met een zuurstofdebiet onder ongeveer 5 L/min?

1. AZuurstof kan bij lage debieten niet worden bevochtigd
2. BDe elastische band zit te los bij lage debieten
3. CUitgeademd CO₂ kan zich in het masker ophopen en opnieuw worden ingeademd
4. DHet masker levert te veel zuurstof bij lage debieten

Een patiënt met hartfalen met een vochtbeperking van 1,5 L/dag klaagt over ernstige dorst. Welke maatregel is het meest geschikt?

1. AZoute snacks om speeksel op te wekken en droogte te verlichten
2. BHelemaal geen vocht tot het wegen van de volgende ochtend
3. CMondzorg, getelde ijsblokjes en vocht gespreid over de dag
4. DOnbeperkt water, want dorst moet altijd worden gelest

Why can a patient with an insulin pump develop DKA within hours if the pump stops working?

1. AThe body becomes allergic to insulin when the pump stops
2. BThe battery in the pump releases chemicals into the blood
3. CThe pump gives only rapid-acting insulin, so there is no long-acting reserve
4. DThe pump gives long-acting insulin, which builds up and stops working all at once

A nurse teaches a patient about peritoneal dialysis. Which statement shows a need for further teaching?

1. A"If the fluid is cloudy, I'll see if it clears next time."
2. B"I will wash my hands carefully before each exchange."
3. C"I will check my exit site every day."
4. D"I will weigh myself daily and record my fluid balance."

Which technique is correct when giving a prefilled low molecular weight heparin injection?

1. ARub the site firmly afterwards to help absorption
2. BExpel the air bubble first and inject into the deltoid muscle
3. CInject into a vein in the back of the hand
4. DLeave the air bubble in and inject into a skin fold

A patient with gallstones has a temperature of 39 °C with rigors, jaundice and right upper abdominal pain. What should the nurse suspect?

1. AUncomplicated reflux
2. BAcute hepatitis A
3. CAscending cholangitis
4. DSimple biliary colic