Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

Which SBAR recommendation is the clearest?

1. A“I just wanted to let you know about him.”
2. B“He seems a bit off tonight, so maybe you could come up and do something about it.”
3. C“I would like you to see him within 15 minutes and consider a fluid bolus.”
4. D“I will keep watching him and call again tomorrow.”

An RN has five patients and a nursing assistant. One patient has just become short of breath. Which task should the RN delegate so that the RN can go to that patient?

1. AMorning vital signs on the four stable patients
2. BExplaining the new diagnosis to the breathless patient’s family
3. CAssessing the breathless patient’s lung sounds
4. DGiving the breathless patient’s IV furosemide

Een verpleegkundige krijgt een prikaccident van een patiënt van wie bekend is dat die hiv heeft. Waarom is het belangrijk dit direct te melden?

1. AMelden is alleen nodig als de wond bloedt of diep is
2. BPostexpositieprofylaxe werkt het best wanneer binnen enkele uren wordt gestart
3. CMelden is alleen nodig bij verwondingen door infuusnaalden
4. DMelden kan binnen een maand op elk moment zonder dat het risico verandert

A nurse has raised a safety concern about an order with the prescriber, who dismissed it without addressing it. What should the nurse do next?

1. AState the concern clearly a second time and, if still unresolved, use the chain of command
2. BRefuse to care for the patient for the rest of the shift until the prescriber apologizes
3. CDiscuss the concern with the patient and let them decide
4. DCarry out the order as written, because the prescriber has heard the concern

A patient has macrocytic anemia with numbness and tingling of the feet and poor balance. Which deficiency is most likely?

1. AVitamin B₁₂
2. BIron (low ferritin)
3. CFolate (folic acid)
4. DVitamin C (ascorbic acid)

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. AVitamin B₁₂ deficiency
2. BVitamin D (calciferol) deficiency
3. CIron deficiency from gut loss
4. DVitamin K deficiency

Welk middel wordt gebruikt om ongefractioneerde heparine te couperen?

1. ANaloxon
2. BProtaminesulfaat
3. CFlumazenil
4. DVitamine K (fytomenadion)

A patient is taught to self-inject low-molecular-weight heparin. Which statement shows a need for further teaching?

1. A"I will inject into the fatty tissue of my abdomen."
2. B"I will rub the area firmly after the injection."
3. C"I will change the injection site each time."
4. D"I will report any unusual bleeding or bruising."

A patient with stable angina is afraid nicotine patches will harm their heart. Which reply is most accurate?

1. APeople with angina must stop smoking without any help
2. BNicotine replacement is much safer than smoking and is recommended
3. CNicotine patches are much more harmful to the heart than cigarettes
4. DNicotine replacement only works if smoking continues

A patient with crushing chest pain has ST elevation in leads V1–V4. Which coronary artery is most likely blocked?

1. AThe left subclavian artery
2. BThe right coronary artery and its branches
3. CThe left anterior descending artery
4. DThe circumflex artery

Why is IV calcium gluconate given in severe hyperkalaemia?

1. AIt protects the heart from arrhythmias
2. BIt binds potassium in the gut
3. CIt moves potassium into the cells
4. DIt removes potassium through the kidneys

A student has fever, a severe headache, a spreading non-blanching rash and a BP of 85/50 mmHg. A lumbar puncture is planned. What is the priority?

1. AGive paracetamol (acetaminophen) and recheck observations in an hour
2. BWait until after the lumbar puncture before giving antibiotics
3. CArrange a CT scan of the head before any treatment
4. DGive IV antibiotics at once and start sepsis treatment

Which advice helps a patient with haemorrhoids?

1. ASit on the toilet for long periods to empty fully
2. BEat more fibre, drink enough fluid and avoid straining
3. CEat less fibre so that stools are smaller
4. DTake a codeine-based painkiller every day

A patient is booked for a urea breath test for H. pylori. Which medicine should usually be stopped 2 weeks before the test?

1. AAmlodipine
2. BOmeprazole
3. CLevothyroxine
4. DParacetamol (acetaminophen)