Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

A parent of a child with influenza talks with the nurse. Which statement shows a need for further teaching?

1. A“I will call if my child has trouble breathing.”
2. B“I will give my child aspirin to bring the fever down.”
3. C“I will keep my child home from school and away from others while unwell.”
4. D“I will give my child plenty of fluids.”

A patient who is 7 weeks pregnant has one-sided lower abdominal pain, pain in the shoulder tip, a heart rate of 120/min and a blood pressure of 88/54 mmHg. What is most likely?

1. ASevere morning sickness
2. BA ruptured ectopic pregnancy
3. CA urinary tract infection
4. DA normal early pregnancy

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

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

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

A patient's potassium is unexpectedly 5,8 mEq/L. The sample was taken after the tourniquet was on for several minutes while the patient pumped their fist. What is the best interpretation?

1. AThe result may be falsely high and should be repeated with better technique
2. BTourniquet time affects only the glucose result, not the potassium
3. CFist pumping lowers potassium, so the true level is even higher
4. DThe result confirms true hyperkalemia and needs no further checking

Een patiënt zonder nierproblemen en met een normaal ECG heeft een kalium van 6,2 mEq/L. Het laboratorium merkt op dat het monster gehemolyseerd was. Wat is de beste interpretatie?

1. ADe patiënt heeft nierfalen
2. BDirect behandelen met insuline en glucose zonder verdere controles
3. CHet kalium is zeker normaal en vraagt geen opvolging
4. DDe uitslag kan vals hoog zijn; beoordeel de patiënt en regel een herhaalmonster

A patient is receiving enteral feeding through a nasogastric tube. How should they be positioned during feeding?

1. ALying completely flat
2. BIn any position, as long as the feed runs slowly
3. CLying on the left side with the head down to help the feed drain
4. DWith the head of the bed raised to at least 30 degrees

A patient with poorly controlled hyperthyroidism develops a high fever, very fast heart rate, agitation and vomiting during an infection. What is likely?

1. AThyroid storm
2. BMyxoedema coma
3. CAddisonian crisis
4. DHypoglycaemia

A patient is starting long-term amiodarone. Which teaching and monitoring are most important?

1. AExpect orange urine and no need for blood tests
2. BAvoid dairy products and have the INR checked once at the start
3. CProtect skin from sunlight and have thyroid, liver and lung checks
4. DEat extra salt and stop the drug as soon as the pulse is regular

A patient has new chest pain at rest. The ECG shows ST depression, but serial troponins remain normal. Which diagnosis fits best?

1. AST-elevation myocardial infarction
2. BStable angina
3. CUnstable angina
4. DNon-ST-elevation myocardial infarction

A patient with type 1 diabetes plans a long cycle ride. Which advice is most appropriate?

1. AAvoid checking glucose until the ride is over
2. BTake an extra dose of rapid-acting insulin before setting off
3. CSkip breakfast so the exercise burns body fat
4. DCheck glucose before and after, and carry fast-acting carbohydrate

Why might a frail 88-year-old with type 2 diabetes have a less strict HbA1c target?

1. ATo reduce the risk of hypos, falls and confusion
2. BBecause diabetes cannot damage older people
3. CTo save money on blood tests and drugs
4. DBecause older people cannot use any glucose medicines

Welke maatregelen helpen tumorlysissyndroom te voorkomen bij hoogrisicopatiënten?

1. AIntraveneuze hydratatie met allopurinol of rasburicase
2. BVochtbeperking met kaliumtabletten
3. CTijdens de chemotherapie alle intraveneuze en orale vloeistoffen staken
4. DDagelijks calcium- en fosfaatsupplementen

Which new prescription for a patient with cirrhosis should the nurse question?

1. ASpironolactone for ascites
2. BLactulose to keep the bowels open
3. CThiamine supplements
4. DRegular ibuprofen for back pain