Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

A patient uses patient-controlled analgesia (PCA) after surgery. Which statement by a family member shows a need for further teaching?

1. A“I will tell the nurse if she becomes very sleepy or hard to wake.”
2. B“The pump has limits set by the nurse so she cannot get too much at once.”
3. C“I will press the button for her while she is asleep so she stays comfortable.”
4. D“Only she should press the button when she needs pain relief.”

A patient has a potassium of 7,0 mEq/L with peaked T waves. Several drugs are prescribed. Which one is usually given first to protect the heart?

1. AIV furosemide
2. BIV calcium gluconate
3. COral potassium binder
4. DOral sodium bicarbonate

A patient with delirium is at risk of falls and of pulling out lines. Which option is less restrictive than restraints?

1. AA trained sitter or video monitoring with staff nearby
2. BA vest restraint applied for the whole night
3. CFour side rails raised and the door closed so the patient stays in bed
4. DA sedative given every few hours as needed

A nurse has just started a unit of red blood cells when a colleague asks for urgent help with another patient. What is the best action?

1. AStay with the transfusing patient for the first 15 minutes and ask another nurse to help
2. BSpeed up the transfusion so it finishes sooner
3. CPause the transfusion until the nurse is free again
4. DLeave to help the other patient, and check the transfusion again in about an hour

Bij chronische nierziekte gaat een hoog serumfosfaat meestal samen met welke verandering in calcium?

1. AEen laag serumcalcium
2. BGeen verandering in calcium
3. CEen hoog serumcalcium
4. DAlleen een hoog serumkalium, zonder verandering in calcium

Van welke patiënt moet de verpleegkundige de uitslag als eerste melden?

1. AGlucose 42 mg/dL (2,3 mmol/L) bij een patiënt die zweet en verward is
2. BHbA1c 7,4% (57 mmol/mol) bij een patiënt met diabetes type 2
3. CTotaal cholesterol iets boven de streefwaarde
4. DCreatinine 1,6 mg/dL (141 µmol/L) bij een patiënt met bekende stabiele CNZ

A pressure ulcer shows full-thickness tissue loss with exposed bone. Which category (stage) is this?

1. ACategory 2
2. BCategory 3
3. CCategory 4
4. DCategory 1

A patient on metformin with reduced kidney function is due a CT scan with IV contrast. Why might metformin be withheld?

1. AMetformin makes the images blurry
2. BMetformin reacts with the contrast to cause severe hyperglycaemia
3. CMetformin causes severe bleeding during scans
4. DThere is a risk of lactic acidosis if kidney function worsens

A patient in cardiac rehabilitation asks how hard to exercise. Which simple guide is commonly taught?

1. AExercise only until the heart rate rises even slightly
2. BExercise until chest pain starts, then stop
3. CExercise until they are too breathless to speak at all
4. DExercise so they are a little breathless but can still talk

Three hours after femoral cardiac catheterisation, a patient has new lower back and flank pain, a heart rate of 112/min and BP 92/60 mmHg. The groin looks normal. What should the nurse suspect?

1. ARetroperitoneal bleeding
2. BA urinary tract infection
3. CNormal back ache from lying flat
4. DAn allergic reaction to the contrast

A patient with Addison's disease takes fludrocortisone as well as hydrocortisone. Why?

1. ATo replace the missing aldosterone
2. BTo lower the blood pressure
3. CTo replace the missing adrenaline
4. DTo treat a low thyroid hormone level

A patient with CKD has a high phosphate, a low calcium and a high PTH. What does this show?

1. AHypoparathyroidism after neck surgery
2. BToo much vitamin D from supplements
3. CPrimary hyperparathyroidism from a tumour
4. DSecondary hyperparathyroidism from CKD

Which risk is particularly linked with tramadol?

1. AHigh blood pressure that needs emergency treatment in most patients
2. BSevere stomach ulcers in all patients
3. CRapid liver failure at normal doses
4. DSerotonin syndrome with some antidepressants, and seizures

Which patient has the highest risk of postoperative nausea and vomiting?

1. AA smoker who has never had nausea after surgery
2. BA male smoker having a short procedure without opioids
3. CA man with no history of nausea having local anaesthetic only
4. DA non-smoking woman with motion sickness who will need opioids