Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

A patient is receiving opioids after surgery. Which finding usually comes before opioid-induced respiratory depression?

1. AIncreasing sleepiness that is hard to rouse
2. BIncreased appetite and thirst
3. CA sudden rise in pain scores
4. DA rise in blood pressure with flushed cheeks

A patient with raised intracranial pressure is being nursed on the ward. Which position is best?

1. ASitting forward with the chin on the chest
2. BFlat on the back with the head turned well over to one side
3. CHead down with the legs raised above the heart
4. DHead of the bed at about 30 degrees with the neck straight

Welk verbandafval moet in klinisch (biologisch risicovol) afval worden weggegooid?

1. AEen ongebruikt, nog verzegeld verband na de houdbaarheidsdatum
2. BDe buitenste papieren verpakking van een steriel verbandpakket
3. CEen schone papieren handdoek waarmee de handen zijn gedroogd
4. DEen verband dat doordrenkt is met vocht uit een geïnfecteerde wond

A patient refuses to wear an identification wristband. What should the nurse do?

1. AStop giving the patient any care until they agree to wear the band
2. BExplain why it is needed, use other ID methods per policy and document
3. CForce the band onto the patient’s wrist
4. DAccept the refusal and identify the patient by room number and bed space instead

Welke behandeling verlaagt het serumkalium door het de cellen in te verplaatsen?

1. AIntraveneuze gewone insuline gegeven met glucose
2. BIntraveneus calciumgluconaat gegeven in 10 minuten
3. CEen intraveneuze infusie van 0,45% natriumchloride
4. DOrale kaliumchloridesuppletie

A patient on stable digoxin starts amiodarone. A week later, the patient has nausea and visual changes, and the digoxin level is above the range. What is the most likely explanation?

1. ADigoxin has raised the amiodarone level
2. BAmiodarone has raised the digoxin level
3. CThe patient has started a viral illness
4. DAmiodarone has lowered potassium only

Why are patients with atrial fibrillation often given anticoagulants?

1. ATo slow the heart rate directly and prevent palpitations
2. BTo convert the rhythm back to normal
3. CTo reduce the risk of stroke from clots in the atria
4. DTo lower the blood pressure

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

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

A patient with chest pain has a first troponin result within the normal range one hour after the pain started. Why is a repeat test arranged?

1. AThe repeat test is only needed for patients over 80
2. BTroponin may take a few hours to rise after muscle damage
3. CTroponin falls during an MI, so a lower value confirms it
4. DThe first sample is always contaminated

A patient with a confirmed type A aortic dissection is hypertensive and tachycardic while awaiting surgery. Which drug class is usually given first to lower the heart rate and blood pressure?

1. AAn intravenous beta-blocker
2. BAn intravenous thrombolytic
3. CAn intravenous fluid bolus
4. DOral aspirin

An 85-year-old care home resident becomes newly confused and is falling more often. A UTI is one possibility. Why?

1. AUrinary infections always cause a high fever in older adults
2. BConfusion is the only symptom of a UTI at any age
3. CA UTI cannot occur in people over 80
4. DOlder adults often show infection as confusion

Een 22-jarige met diabetes type 1 heeft glucose 28 mmol/L, ketonen 5,2 mmol/L, pH 7,10 en kalium 5,9 mmol/L. Welke bewering over kalium is juist?

1. AHet totale kalium in het lichaam is hoog, dus er is nu een kaliumbinder nodig
2. BHet totale kalium in het lichaam is laag en de spiegel zal dalen met de behandeling
3. CKalium hoeft niet opnieuw te worden gecontroleerd zodra insuline is gestart
4. DDe insuline moet worden achtergehouden om de kaliumspiegel stabiel te houden

Before an anti-TNF biologic such as infliximab is started for Crohn's disease, which screening is essential?

1. AA test for coeliac disease
2. BA bone density scan
3. CScreening for tuberculosis
4. DA test of colour vision

A patient with a toe ulcer says the leg pain is worse at night and eases when they hang the leg over the side of the bed. What does this suggest?

1. AArterial insufficiency
2. BLymphoedema
3. CNeuropathic itching
4. DVenous insufficiency