Priorytetyzacja i delegowanie w stylu NCLEX: zestaw na powtórkę

A patient with severe neutropenia needs a room. Which roommate is the safest choice?

1. AA patient after a knee replacement with no signs of infection
2. BA patient with an infected, draining leg wound
3. CA patient with C. difficile diarrhea
4. DA patient with influenza

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

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

Before helping a patient from bed into a wheelchair, what should the nurse do with the wheelchair?

1. APlace it on the patient’s weaker side so that side is supported
2. BPlace it at the foot of the bed, facing away
3. CLeave the brakes off so the chair can move along with the patient during the pivot
4. DLock the brakes and place it close to the bed on the patient’s stronger side

A patient with pulmonary tuberculosis has been on treatment. Which findings usually allow airborne isolation to end?

1. AThe cough has stopped, even with no sputum tests
2. BThe patient has been in hospital for one week and has taken every dose of medicine
3. CThree negative sputum smears, clinical improvement and continued therapy
4. DOne negative chest x-ray after starting treatment

Kiedy należy pobrać posiewy krwi u pacjenta z podejrzeniem sepsy?

1. APo pierwszych trzech dawkach antybiotyków
2. BW dowolnym momencie, ponieważ antybiotyki nie wpływają na wynik
3. CPrzed pierwszą dawką antybiotyku, bez znacznego jej opóźniania
4. DTylko jeśli gorączka trwa dłużej niż trzy dni

A patient in DKA is receiving IV fluids and insulin. The glucose has fallen to about 220 mg/dL (12,2 mmol/L), but the anion gap is still high. What change would the nurse expect?

1. AStop the insulin infusion because the glucose is near normal
2. BGive an IV bolus of sodium bicarbonate at once
3. CStop the IV fluids and start oral fluids only
4. DAdd dextrose to the IV fluids and continue the insulin

Which factor is most likely to slow wound healing?

1. AA diet rich in protein
2. BSmoking
3. CGood blood glucose control
4. DAdequate fluid intake

Dwa dni po resekcji jelita pacjent ma narastający ból, gorączkę, tachykardię, a w drenie z rany pojawia się treść przypominająca kał. Co jest najbardziej prawdopodobne?

1. APrawidłowy przebieg pooperacyjny
2. BNieszczelność zespolenia
3. CZatrzymanie moczu
4. DZaparcie

Dlaczego przewodu drenu klatki piersiowej zasadniczo nie wolno zaciskać?

1. AZaciśnięcie trwale osłabia i pęka przewód
2. BZaciśnięcie powoduje zbyt szybkie odpływanie płynu z klatki piersiowej
3. CZaciśnięcie powoduje parowanie wody w uszczelnieniu
4. DUwięzione powietrze może się gromadzić i spowodować odmę prężną

Two days after a coronary stent, a patient on aspirin and ticagrelor has black, tarry stools and feels faint on standing. What should the nurse do?

1. AReassure the patient that iron tablets cause black stools
2. BGive a laxative and repeat the observations tomorrow
3. CCheck vital signs, report urgently and anticipate a blood count
4. DStop both antiplatelet drugs permanently on the nurse's own decision

A patient on insulin asks about drinking alcohol. Which advice is correct?

1. AAlcohol has no effect on blood glucose in people with diabetes
2. BAlcohol should replace a meal on the days it is drunk
3. CAlcohol can cause hypos, even the next day, so eat carbs with it
4. DAlcohol raises glucose, so extra insulin should be taken first

A day after a total thyroidectomy, a patient has tingling lips, a positive Chvostek's sign and a corrected calcium of 1,85 mmol/L (about 7,4 mg/dL). What does the nurse expect?

1. AA loop diuretic to remove the extra calcium
2. BIV potassium chloride and a fluid restriction
3. CIV calcium gluconate and monitoring for laryngospasm
4. DOral levothyroxine, with a recheck of the calcium in a month

What is a Curling's ulcer?

1. AA stress ulcer of the stomach or duodenum after a major burn
2. BA burn on the sole of the foot
3. CA pressure ulcer under a splint that has been left on too long
4. DA leg ulcer caused by venous disease after long bed rest

An older patient with atrial fibrillation has sudden severe abdominal pain, but the abdomen is soft with little tenderness. Lactate is raised. What should the nurse suspect?

1. AAcute mesenteric ischaemia
2. BIrritable bowel syndrome
3. CSimple constipation
4. DMuscle strain from coughing