Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

Which action helps prevent a catheter-associated urinary tract infection?

1. AKeeping the drainage bag below the level of the bladder
2. BLeaving the catheter in place longer than needed
3. CDisconnecting the bag every shift to empty it
4. DRaising the drainage bag above the bladder when walking

Several patients on a unit develop diarrhea within two days. What should the nurse do first?

1. AWait to see if more patients become unwell
2. BGive all patients antidiarrheal drugs without assessment
3. CMove the affected patients into shared rooms with other patients to free up beds
4. DPlace affected patients on contact precautions and inform infection control

A patient with a severe latex allergy is booked for surgery. Which measure is commonly used?

1. AUse latex-free supplies and schedule the patient as the first case of the day
2. BGive the patient antihistamines before surgery and then use the normal supplies
3. CWrap latex items in plastic before use
4. DUse latex gloves only for short procedures

A nurse finds an unknown liquid leaking from a container in the utility room, with a strong smell. What should the nurse do first?

1. ALeave the area, keep others out and alert the trained response team
2. BPour water over it to dilute it
3. CMove closer and smell it carefully to identify what the substance is
4. DMop it up with paper towels

Welke beoordeling is het belangrijkst voordat voorgeschreven intraveneus kaliumchloride wordt gegeven?

1. AUrineproductie en nierfunctie
2. BHuidturgor op de onderarm
3. CGehoor in beide oren
4. DPupilgrootte en lichtreactie

Which cerebrospinal fluid (CSF) pattern most strongly suggests bacterial meningitis?

1. ACloudy fluid, low glucose, high protein, many neutrophils
2. BClear fluid, normal glucose, normal protein, no white cells
3. CClear fluid, high glucose, low protein, many red cells
4. DClear fluid, normal glucose, mildly raised protein, lymphocytes

What happens in third-degree (complete) heart block?

1. ANo impulses from the atria reach the ventricles, so they beat independently
2. BThe ventricles beat very fast and regularly
3. CThe atria beat chaotically with no P waves, and the ventricular rate is irregular
4. DEvery impulse reaches the ventricles, but each one is slightly delayed

Why must a unit of red cells be transfused within the set time limit (commonly four hours) after it leaves controlled cold storage?

1. AThe bag stops dripping after four hours
2. BBacteria can grow in the blood at room temperature
3. CThe blood group of the cells changes after a few hours
4. DThe red cells break down and turn into plasma

Why should a long-acting beta-2 agonist (LABA) never be used alone in asthma?

1. AIt works only when it is taken together with a course of antibiotics
2. BIt cannot be inhaled without a nebuliser
3. CWithout an inhaled steroid, it is linked with severe and fatal attacks
4. DIt always causes immediate severe bronchospasm when used on its own

Ten days after cardiac surgery, a patient has a fever, a red sternal wound with discharge and a clicking feeling in the chest when coughing. What should the nurse suspect?

1. ASternal wound infection with an unstable sternum
2. BNormal wound healing with some expected discharge
3. CCostochondritis caused by forceful coughing
4. DPericarditis from the operation

A conscious patient with a glucose of 3,1 mmol/L (56 mg/dL) can swallow safely. Which is the best first treatment?

1. AA dose of rapid-acting insulin with a sandwich
2. BGlucose tablets or a small glass of fruit juice
3. CA chocolate bar and a cup of tea with milk
4. DA glass of milk and two plain biscuits

Een oudere man heeft 10 uur niet geplast, heeft pijn in de onderbuik en een blaasscan van 1100 mL. Het creatinine is gestegen. Wat is de meest waarschijnlijke oorzaak en handeling?

1. ADiabetes insipidus; desmopressine geven en vocht beperken
2. BContrastnefropathie; vandaag spoedhemodialyse regelen
3. CUrineretentie; katheteriseren volgens voorschrift en letten op een grote diurese
4. DUitdroging; een vochtbolus geven en morgen het creatinine opnieuw controleren

A routine wound swab grows bacteria, but the wound shows no signs of infection. What does this usually mean?

1. AThe wound is colonised; antibiotics are not usually needed
2. BThe wound must be closed with sutures again
3. CThe patient needs IV antibiotics straight away, whatever the wound looks like
4. DThe swab result means the wound is infected

Four hours after surgery, a catheterised patient's urine output has been 10 mL/h for two hours. Vital signs are stable. What should the nurse check first?

1. AThe time the patient last ate
2. BWhether the patient wants a cup of tea
3. CYesterday's chest X-ray and blood gas results
4. DThat the catheter and tubing are not kinked or blocked