Priorytetyzacja i delegowanie w stylu NCLEX: zestaw na powtórkę

A patient is admitted with diabetic ketoacidosis. Which prescribed treatment is usually started first?

1. AA high-carbohydrate meal
2. BSubcutaneous long-acting insulin only, given once
3. CIV isotonic fluid such as 0,9% sodium chloride
4. DOral potassium tablets

A patient is bleeding internally after a fall. Which finding is usually an early sign of hypovolemic shock?

1. AA slow heart rate with warm, dry, flushed skin and a normal blood pressure throughout
2. BA very low blood pressure with fixed, dilated pupils
3. CRestlessness and a rising heart rate while the blood pressure is still normal
4. DLoss of consciousness with gasping breaths

A patient with difficulty swallowing is prescribed an extended-release tablet. What should the nurse do?

1. ADissolve the tablet in a glass of hot water
2. BAsk the prescriber or pharmacist for another form and not crush the tablet
3. CCut the tablet in half so it is easier to swallow
4. DCrush the tablet finely and mix it into a spoonful of applesauce or yogurt

Several patients arrive with suspected inhalational anthrax after a deliberate release. Which precautions are needed for their care?

1. AAirborne precautions in negative-pressure rooms, because spores are inhaled
2. BContact precautions with gowns and gloves
3. CStandard precautions, because it is not spread from person to person
4. DDroplet precautions with surgical masks

A patient has burning on urination and frequency. The dipstick is positive for nitrites and leukocyte esterase, and a urine culture is ordered. When should the sample be taken?

1. AAfter the symptoms have fully settled
2. BAfter 3 days of antibiotic treatment
3. CBefore the first dose of antibiotic
4. DAt any time, as antibiotics do not matter

The nurse teaches a patient who is collecting a 24-hour urine sample at home. Which statement shows a need for further teaching?

1. A"I'll keep the container cool as the laboratory told me to"
2. B"If I forget to save one void, I'll just carry on to the end"
3. C"I'll ask whether any foods or drugs should be avoided first"
4. D"I'll empty my bladder at the end time and add that urine"

Which group of symptoms suggests hypercalcaemia?

1. AWeight gain, feeling cold and a slow pulse
2. BTingling lips, muscle cramps and spasms of the hands and feet
3. CSweating, tremor and sudden hunger
4. DThirst, constipation, confusion and abdominal pain

Why can pulse oximetry be misleading in carbon monoxide poisoning?

1. ACarbon monoxide only affects the heart rate reading
2. BStandard oximeters cannot tell carboxyhaemoglobin from oxyhaemoglobin
3. CThe oximeter overheats in smoke-exposed patients
4. DCarbon monoxide makes the oximeter read zero even in a well patient

A patient has chest pain at rest in the early morning with brief ST elevation that resolves. Coronary arteries are later found to be clear. Which condition is most likely?

1. AVasospastic (Prinzmetal) angina
2. BAcute pericarditis
3. CAortic stenosis
4. DStable exertional angina from a fixed plaque

Przed poranną dawką digoksyny tętno koniuszkowe pacjenta wynosi 54/min i pacjent odczuwa nudności. Co powinna zrobić pielęgniarka?

1. APodać dawkę, ponieważ liczy się tylko tętno na tętnicy promieniowej
2. BWstrzymać dawkę i zgłosić, ponieważ możliwe jest zatrucie
3. CPodać połowę dawki i sprawdzić tętno za godzinę
4. DPodać dawkę i lek przeciwwymiotny, a tętno sprawdzić ponownie jutro

Dlaczego po tyreoidektomii przy łóżku często trzyma się narzędzia do usuwania szwów lub klipsów?

1. AKrwiak szyi może uciskać drogi oddechowe i może wymagać odbarczenia
2. BSzwy trzeba usunąć pierwszego wieczoru po operacji
3. CSą potrzebne do pobierania krwi z żył szyi
4. DSłużą do regulacji drenu, gdy przestaje działać

A patient with CKD has a high phosphate, a low calcium and a high PTH. What does this show?

1. APrimary hyperparathyroidism from a tumour
2. BSecondary hyperparathyroidism from CKD
3. CToo much vitamin D from supplements
4. DHypoparathyroidism after neck surgery

Which check is routinely made for a patient with a burn wound?

1. AVisual acuity in both eyes
2. BMeasles vaccination status
3. CBlood group of the next of kin
4. DTetanus immunisation status

Skóra wokół ileostomii pacjenta jest czerwona, zdarta i sącząca, a worek często przecieka. Jaka jest najbardziej prawdopodobna przyczyna?

1. AWydzielina na skórze, często z powodu źle dopasowanego worka
2. BNormalna reakcja niewymagająca zmiany opieki
3. CAlergia na sam stolec, wymagająca sterydów
4. DNiedokrwienie stomii wymagające pilnej operacji