Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

Before giving a medication to a child, which check is especially important?

1. AThat the parent agrees with the time it is given
2. BThat the medicine cup is the child’s favorite color
3. CThat the dose is correct for the child’s weight
4. DThat the child likes the taste of the drug

Een patiënt met een bloeding in het bovenste maag-darmkanaal heeft een hartfrequentie van 128/min en een bloeddruk van 84/50 mmHg. Dit alles is voorgeschreven. Welke start de verpleegkundige als eerste?

1. AOrale ijzertabletten
2. BEen intraveneuze protonpompremmer-infusie
3. CDe diagnostische endoscopie voor de volgende ochtend boeken
4. DIntraveneuze vloeistof of bloed via dikke canules

Why is blood glucose control important around the time of surgery?

1. ALow glucose is needed around surgery so that the wound edges close more quickly
2. BGlucose levels only affect patients who have type 1 diabetes
3. CHigh glucose impairs white cell function and raises the risk of surgical site infection
4. DHigh glucose makes anesthetic drugs work for much longer and delays waking up

A nurse finds that a patient has been taking their own sleeping pills from a bedside drawer while also receiving a hypnotic from the ward. What should the nurse do?

1. AThrow the patient’s pills away in the bin
2. BStop giving the hospital hypnotic without telling the provider or the pharmacy
3. CLet the patient keep them, since they are the patient’s own
4. DSecure the home medication per policy and inform the provider

A stool test for Clostridioides difficile is ordered. Which sample is appropriate?

1. AAn unformed (liquid or soft) stool
2. BA rectal swab from a patient with constipation
3. CAny stool after a laxative dose
4. DA formed, hard stool sample

A man of Mediterranean descent develops dark urine, jaundice and a falling hemoglobin a few days after eating fava beans. Which condition is most likely?

1. AVitamin B₁₂ deficiency anemia
2. BIron-deficiency anemia from poor diet
3. CG6PD deficiency with acute hemolysis
4. DSickle cell crisis with vaso-occlusion

After a total hip replacement through a posterior approach, which movement should the patient usually avoid in the early weeks?

1. ADoing gentle ankle exercises
2. BBending the hip beyond 90 degrees or crossing the legs
3. CLying on their back
4. DWalking short distances with a frame and a physiotherapist

An older man has sudden severe abdominal and back pain, is hypotensive and has a pulsating mass in the abdomen. What should be suspected?

1. AAcute gastritis from anti-inflammatory drugs
2. BMusculoskeletal back pain
3. CRenal colic from a kidney stone
4. DA ruptured abdominal aortic aneurysm

What is the main difference between CPAP and bilevel NIV (often called BiPAP)?

1. ACPAP is mainly used to lower a raised PaCO₂ in COPD exacerbations
2. BCPAP is given only through a tracheostomy
3. CBilevel NIV gives oxygen only, without any positive airway pressure
4. DBilevel NIV adds a higher inspiratory pressure, helping remove CO₂

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. BPericarditis from the operation
3. CNormal wound healing with some expected discharge
4. DCostochondritis caused by forceful coughing

Which nursing care is most important for a patient with diabetes insipidus?

1. AA strict fluid restriction to reduce the amount of urine passed
2. BStrict fluid balance, daily weight and free access to water
3. CWeighing the patient once a month
4. DGiving a loop diuretic to clear extra fluid

After a TURP, a patient on bladder irrigation has bladder spasms. The drainage has slowed and contains clots, and the bag holds less than the irrigant given. What should the nurse do first?

1. ATurn off the irrigation and leave the catheter alone
2. BEncourage the patient to strain to pass the clots
3. CSuspect a clot in the catheter and follow the protocol
4. DGive an antispasmodic and recheck in four hours

Which practice is correct when giving parenteral nutrition through a central line?

1. AGive other IV drugs through the same lumen to save time
2. BLet the bag hang at room temperature for several days
3. CDisconnect and reconnect the line without cleaning the hub
4. DUse a dedicated lumen and strict aseptic technique

Een patiënt krijgt negatievedruktherapie voor een wond (NPWT). De pomp alarmeert en het verband heeft zijn afdichting verloren. Wat is de meest geschikte handeling?

1. ADe afdichting herstellen; als dat niet op tijd lukt, overstappen op een vochtig verband
2. BDe wond opvullen met droog gaas over het schuim en strak vastplakken
3. CDe zuiging op de maximale stand zetten om de afdichting terug te trekken
4. DHet schuim zonder zuiging enkele dagen in de wond laten tot de beoordeling