Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

Een verpleegkundige delegeert het meten van de bloedglucose aan een getrainde assistent maar vraagt nooit om de uitslag. Welk juist punt van delegeren ontbreekt?

1. AJuiste persoon voor de taak
2. BJuist toezicht en evaluatie
3. CJuiste taak voor de setting
4. DJuiste omstandigheid

Four patients arrive at the emergency department at the same time. Who should be seen first?

1. AA young adult with a swollen, painful ankle after a fall on the stairs
2. BAn adult with kidney stone pain of 9/10 and stable vital signs
3. CAn older adult with weakness on one side that began 40 minutes ago
4. DA child with a temperature of 39 °C who is alert and drinking

In the US (EPA/OSHA) hazmat system, which level of PPE gives the highest level of protection?

1. ALevel D
2. BLevel B
3. CLevel A
4. DLevel C

A nurse finds that a patient has been taking their own sleeping pills from a bedside drawer while also receiving a hypnotic from the ward. What should the nurse do?

1. ALet the patient keep them, since they are the patient’s own
2. BStop giving the hospital hypnotic without telling the provider or the pharmacy
3. CThrow the patient’s pills away in the bin
4. DSecure the home medication per policy and inform the provider

Een patiënt die al twee dagen braakt heeft een BUN van 32 mg/dL (ureum 11,4 mmol/L) en een normaal creatinine. Wat is de meest waarschijnlijke oorzaak?

1. AOverhydratie
2. BLeverfalen
3. CUitdroging
4. DEiwitarm dieet

A young woman with frequent self-induced vomiting has swollen salivary glands. Which laboratory pattern is most likely?

1. ALow potassium, high bicarbonate and high amylase
2. BHigh calcium, high phosphate and high glucose
3. CHigh potassium, low bicarbonate and low amylase
4. DLow sodium, low bicarbonate and high lipase

A patient receives IV furosemide for fluid overload. Which findings show the treatment is working?

1. AA rise in weight and more lung crackles
2. BA rise in blood pressure and a new cough
3. CFalling urine output, new ankle swelling and a rise in weight
4. DIncreased urine output, less breathlessness and a falling weight

A healthcare assistant reports four observations. Which one needs the nurse's immediate action?

1. A"Ms Ali has walked to the bathroom on her own."
2. B"Mr Patel's breathing rate is 8 a minute and he's hard to wake."
3. C"Mr Chen's blood pressure is 128/80 as usual."
4. D"Mrs Jones would like a cup of tea and her glasses cleaned."

A patient with an implantable cardioverter-defibrillator asks what to do if it fires. Which teaching is correct?

1. AOne shock and well: contact the device clinic; repeated shocks or unwell: call emergency services
2. BIgnore any shock at all, because the device is designed to fire every day and needs no follow-up
3. CRemove the device battery at home if it fires more than once
4. DDrive straight to hospital alone after any shock so the device can be checked by the team

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

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

A man starts tamsulosin for BPH. Which teaching point is most important?

1. AStand up slowly, because it can make you dizzy
2. BTake it with grapefruit juice to make it work better
3. CStop it if the urine stream improves
4. DExpect the drug to shrink the prostate within a day

A kidney transplant recipient has had vomiting and diarrhoea for two days. Why should the transplant team be contacted?

1. AThe kidney will start to produce far too much urine
2. BThe patient may not be absorbing their immunosuppressants
3. CThe tablets will make the vomiting stop
4. DVomiting proves that rejection has already happened

Why are accurate fluid balance charts kept after major surgery?

1. ATo decide which meal the patient will have next
2. BTo detect dehydration, fluid overload or kidney problems early
3. CTo record when visitors come and go
4. DTo check how far the patient has walked and how often they get out of bed

Hours after an oesophageal dilatation, a patient has chest pain, fever and crackling swelling under the skin of the neck. What should the nurse suspect?

1. ASimple reflux after the dilatation
2. BNormal discomfort after the procedure
3. COesophageal perforation
4. DAn allergic reaction to the sedative