Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

A patient has a serum potassium of 6,8 mEq/L. Which action comes first?

1. ARecheck the level next week
2. BEncourage foods high in potassium
3. CPlace the patient on a cardiac monitor
4. DGive the patient’s scheduled potassium supplement

Welke taak kan de RN het best zelf doen in plaats van te delegeren aan een zorgassistent?

1. AEen stabiele patiënt op de derde dag na de operatie een eindje door de gang laten lopen
2. BElke ochtend een patiënt met hartfalen wegen
3. CEen patiënt voor het eerst na een operatie uit bed halen
4. DEen patiënt helpen met mondverzorging

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

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

A nurse notices that the pharmacy has sent the wrong dose and corrects it before giving it. Should the event be reported?

1. ANo, because the patient was not harmed
2. BOnly if the same error happens three times
3. CNo, because reporting near misses only blames the pharmacy staff for nothing
4. DYes, near misses are reported so system weaknesses can be fixed

A patient who is breathless during a transfusion has hypotension, fever and bilateral lung infiltrates, with no signs of fluid overload. Which complication is most likely?

1. ATransfusion-associated circulatory overload
2. BA mild febrile nonhemolytic reaction
3. CA simple allergic reaction with hives
4. DTransfusion-related acute lung injury (TRALI)

Het totaal calcium van een patiënt is 7,9 mg/dL (2,0 mmol/L), met een albumine van 2,4 g/dL (24 g/L) en zonder klachten. Welke test verduidelijkt het best of er echte hypocalciëmie is?

1. AEen HbA1c
2. BEen soortelijk gewicht van de urine
3. CEen geïoniseerd calcium
4. DEen serumnatrium

Een patiënt met diabetes type 2 is acuut ziek, sterk uitgedroogd en heeft een bloedglucose van 40 mmol/L zonder noemenswaardige ketonen. Wat is de waarschijnlijkste diagnose?

1. AHyperosmolaire hyperglykemische toestand
2. BDiabetes insipidus
3. CDiabetische ketoacidose met uitdroging
4. DHypoglykemie

An adult with capacity refuses a blood transfusion for religious reasons, even though it may save their life. What should the nurse do?

1. AAsk a family member to consent instead
2. BSedate the patient so the transfusion can be given
3. CGive the transfusion while the patient is asleep, as it is in their best interests
4. DRespect the refusal, check it is informed and document it, and inform the team

Which exercise advice is recommended for intermittent claudication?

1. AStopping walking at the very first twinge of pain each time
2. BSupervised walking until pain is near maximal, then rest and repeat
3. CComplete bed rest until the leg pain has gone for at least a month
4. DWalking only on days when the legs feel warm and painless

A patient with a large pericardial effusion has a systolic pressure that falls by more than 10 mmHg during inspiration. What is this finding called?

1. APulsus paradoxus
2. BPulsus alternans
3. CA collapsing pulse
4. DA pulse deficit

What does a positive pronator drift test show?

1. ALoss of hearing on one side
2. BWeakness of the eye muscles
3. CA normal response in older adults
4. DSubtle weakness in one arm

Een beademde patiënt heeft traumatisch hersenletsel. Welke PaCO₂-streefwaarde wordt meestal nagestreefd, tenzij herniatie dreigt?

1. AElke PaCO₂, want die heeft geen invloed op de intracraniële druk
2. BNormale PaCO₂ (normocapnie)
3. CLage PaCO₂ door langdurige hyperventilatie
4. DHoge PaCO₂ om de hersenvaten te openen

A day after a spinal anaesthetic, a patient has a headache that is worse when sitting up and better when lying flat. What is the most likely cause?

1. ARaised blood pressure from pain
2. BPost-dural puncture headache
3. CMigraine caused by hospital lighting
4. DA side effect of the antibiotic

A colleague suggests giving a saline injection to see whether a patient's pain is "real". What is the best response?

1. AIt should be done only for patients with chronic pain
2. BIt is acceptable if a senior nurse gives the saline
3. CIt is a good idea, as long as the patient is not told about it afterwards
4. DDeceptive placebos are unethical and do not show pain is "fake"