Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

A pregnant nurse is on the unit. Which patient should the charge nurse avoid assigning to her?

1. AA patient after a hip replacement
2. BA patient with a sealed radioactive implant for cervical cancer
3. CA patient with type 2 diabetes who needs insulin teaching before discharge
4. DA patient with a fractured wrist

A patient with a head injury has a pupil on one side that is now large and does not react to light. What should the nurse do?

1. ADocument it, because pupils often differ slightly after a head injury
2. BRecheck it at the next routine observation in four hours
3. CDim the room lights so the pupil can get smaller
4. DReport it at once, as it may mean the brain is being compressed

Welk schoonmaakmiddel wordt aanbevolen voor de kamer van een patiënt met Clostridioides difficile?

1. AEen geparfumeerde luchtverfrisser
2. BAlcoholdoekjes, twee keer per dag op alle oppervlakken gebruikt
3. CGewoon water en een schone microvezeldoek
4. DEen sporendodend middel, zoals een oplossing op basis van chloor

Een verpleegkundige komt bij een brand in een gang die zich uitbreidt. In nabijgelegen kamers liggen patiënten. Wat moet de verpleegkundige doen nadat alarm is geslagen?

1. ADeuren sluiten en patiënten in gevaar horizontaal verplaatsen achter brandwerende deuren
2. BAlle deuren en ramen openen zodat de rook kan ontsnappen
3. CPatiënten met de dichtstbijzijnde lift naar de begane grond brengen
4. DProberen de zich uitbreidende brand alleen met een brandblusser te blussen

Why is a baseline platelet count taken before starting heparin therapy?

1. ABecause heparin increases the platelet count to dangerous levels
2. BSo that the INR can be calculated from the platelet count later
3. CSo a later fall from heparin-induced thrombocytopenia is detected
4. DBecause heparin is given at a dose based on the platelet count

A woman with preeclampsia is receiving IV magnesium sulfate. Her urine output has fallen and her creatinine is rising. Why is this a concern?

1. AMagnesium is excreted by the kidneys, so it can build up to toxic levels
2. BPoor kidney function makes the magnesium level fall quickly
3. CMagnesium is broken down by the liver, so it will stop working soon
4. DMagnesium causes potassium loss, so the kidneys release more fluid

Een patiënt met levercirrose wordt verward en suf, met een fladderende tremor van de handen. Welke complicatie is waarschijnlijk?

1. AHypoglykemie door insuline
2. BBeroerte
3. CHepatische encefalopathie
4. DAlleen alcoholintoxicatie

A patient with an epidural catheter develops new back pain and increasing leg weakness when the block should be wearing off. What should be suspected?

1. AMild hypokalaemia
2. BMuscle strain from lying in the same position in bed for many hours
3. CThe normal expected effect of the local anaesthetic
4. DAn epidural haematoma or abscess compressing the spinal cord

Why is a raised serum lactate concerning in a patient with shock?

1. AIt suggests tissues are short of oxygen and using anaerobic metabolism
2. BIt means the kidneys are working harder than normal to clear fluid
3. CIt shows only that the patient has eaten a large meal in the past hour
4. DIt confirms a bacterial infection is present

An adult inhales a peanut while laughing and now has a persistent cough and wheeze on one side. Where is the peanut most likely to have lodged?

1. AThe left main bronchus
2. BThe right main bronchus
3. CThe nasal cavity
4. DThe oesophagus

After a kidney biopsy, which observation is most important?

1. AThe colour of the patient's skin on the face
2. BSigns of bleeding, such as haematuria and a rising pulse
3. CThe patient's appetite at the next meal
4. DThe temperature every four hours only

A patient taking an SGLT2 inhibitor is booked for major surgery. Which statement is correct?

1. AThe dose is usually doubled on the morning of surgery
2. BSurgery is not possible in patients taking this drug
3. CIt is usually paused in the days before surgery
4. DThe drug must be taken right up until the operation starts

Why is a pregnancy test often done before surgery in women who could be pregnant?

1. APregnant women cannot sign consent forms
2. BIt is needed to calculate the anaesthetic drug dose
3. CAnaesthesia, drugs and some tests may harm a fetus
4. DPregnancy always makes surgery impossible

A patient on chemotherapy has white plaques on the tongue and cheeks that wipe off to leave red areas. What is most likely?

1. AOral candidiasis
2. BFood residue only
3. CNormal mucositis healing
4. DLeukoplakia from smoking