Priorytetyzacja i delegowanie w stylu NCLEX: zestaw na powtórkę

A patient is raising his voice, pacing and clenching his fists. What should the nurse do first?

1. AStand very close to him and tell him firmly and loudly to sit down and be quiet
2. BSpeak calmly, keep a safe distance and invite him to talk about what is wrong
3. CApply physical restraints at once
4. DTurn away and ignore the behavior

A trauma patient has an open leg fracture, absent breath sounds on one side, a trachea shifted to the other side and a falling blood pressure. Which problem is the priority?

1. AThe open fracture of the leg
2. BThe risk of wound infection
3. CThe pain from the fracture
4. DThe suspected tension pneumothorax

A parent calls because a toddler has swallowed some household cleaner. The child is awake and breathing normally. What should the nurse advise first?

1. AContact the local poison advice service now for specific advice
2. BWait to see whether any symptoms develop over the next day
3. CGive syrup of ipecac from the medicine cabinet
4. DMake the child vomit, using a finger at the back of the throat

A patient on a general ward for two days is found to have smear-positive pulmonary TB. What should the nurse do besides moving the patient to an airborne isolation room?

1. ANothing more, because the patient has now been isolated
2. BTell all the exposed patients to start TB drugs at once, before any testing
3. CClose the ward to all new admissions for a full year
4. DInform infection prevention so exposed patients and staff can be identified and followed up

Pacjent przyjmujący warfarynę z powodu migotania przedsionków ma INR 5,2 i nie krwawi. Jakie jest najlepsze działanie pielęgniarki?

1. APodać podwójną dawkę
2. BWstrzymać dawkę warfaryny i poinformować lekarza zlecającego
3. CPodać zwykłą dawkę i powtórzyć badanie za miesiąc
4. DPoradzić pacjentowi, aby od dziś przestał jeść zielone warzywa

A patient on digoxin has a calcium of 12,1 mg/dL (3,0 mmol/L) and new nausea and a slow pulse. Why is the calcium result important?

1. AHigh calcium only matters if the potassium is also high
2. BHigh calcium blocks digoxin, so the drug stops working
3. CHigh calcium makes the kidneys clear digoxin faster
4. DHigh calcium increases the risk of digoxin toxicity

A very anxious patient breathes rapidly for a long period. Which change is expected?

1. ARespiratory acidosis from a high PaCO₂
2. BMetabolic alkalosis from vomiting
3. CRespiratory alkalosis from a low PaCO₂
4. DMetabolic acidosis from a low bicarbonate

A patient with central chest pain has ST elevation on the 12-lead ECG. What is the main aim of urgent treatment?

1. AStarting a cholesterol-lowering drug before any other treatment is given
2. BRestoring blood flow through the blocked coronary artery quickly
3. CWaiting for the troponin result before taking any action
4. DStrict bed rest for several days before deciding on treatment

U pacjenta stwierdzono podwyższone stężenie peptydu natriuretycznego typu B (BNP lub NT-proBNP). Co to głównie odzwierciedla?

1. ARozciągnięcie i przeciążenie ciśnieniowe komór
2. BNiedokrwienne uszkodzenie mięśnia sercowego
3. CUszkodzenie mięśni szkieletowych po upadku
4. DZapalenie wątroby wywołane zastojem

A patient being treated for pulmonary TB repeatedly misses doses and stops when they feel better. Which strategy is most effective?

1. ADirectly observed therapy with support for barriers to adherence
2. BSwitching to a single drug to make it easier
3. CStopping treatment, as it is clearly not working for this patient
4. DDoubling the dose on the days the patient remembers to take it

Pacjent ma trudne do opanowania nadciśnienie i stale niskie stężenie potasu, nie przyjmując diuretyków. Jakie schorzenie należy rozważyć?

1. APierwotną niedoczynność tarczycy
2. BPierwotną niewydolność kory nadnerczy (chorobę Addisona)
3. CMoczówkę prostą ośrodkową
4. DPierwotny hiperaldosteronizm (zespół Conna)

A patient with a known ureteric stone develops a fever of 39 °C (102,2 °F) and rigors. Scanning shows a blocked, swollen kidney. What is needed?

1. AStrong pain relief alone, then discharge
2. BA fluid restriction to reduce the swelling
3. COral antibiotics and waiting for the stone to pass
4. DUrgent drainage of the kidney plus IV antibiotics

A patient had an upper GI endoscopy with a local anaesthetic throat spray. What must the nurse check before giving a drink?

1. AThat the patient's blood glucose is above normal
2. BThat bowel sounds are present in all four quadrants
3. CThat swallowing and the gag reflex have returned
4. DThat the patient has passed urine since the procedure

A nurse teaches a carer about overnight tube feeding at home. Which statement shows a need for further teaching?

1. A"I'll stop the feed and call if he coughs or struggles to breathe."
2. B"I'll check the external length mark on the tube every day."
3. C"I'll flush the tube with water before and after his medicines."
4. D"I'll let him lie flat so he sleeps better while the feed runs."