Priorytetyzacja i delegowanie w stylu NCLEX: zestaw na powtórkę

A patient wants to leave the hospital against medical advice. What should the nurse do?

1. ALock the door so the patient cannot leave the unit
2. BHide the patient’s clothes and belongings until the provider arrives
3. CInform the provider, explain the risks and document the discussion
4. DLet the patient leave without telling anyone

During an infusion of a thrombolytic drug for stroke, the patient develops a severe headache and starts vomiting. What should the nurse do first?

1. AContinue the infusion, because headache is expected
2. BStop the infusion and inform the provider at once
3. CGive a dose of aspirin for the headache
4. DSlow the infusion and give an antiemetic as prescribed

Which PPE does a nurse wear when giving an IV chemotherapy drug?

1. ATwo pairs of chemotherapy-tested gloves and a disposable impermeable gown
2. BA reusable cloth gown and one pair of gloves
3. COne pair of standard latex gloves, changed after the infusion is started
4. DA surgical mask and no gloves

A patient’s cardiac monitor alarms often because of artifact, and a colleague suggests turning the alarm off. What is the best response?

1. AKeep the alarm on, fix the cause such as electrode placement, and adjust limits only per policy
2. BTurn the alarm off and check the monitor screen at the nurses’ station every hour instead
3. CTurn the alarm volume down as low as it will go
4. DDisconnect the monitor overnight so the patient can sleep

Which change in clotting tests is normal in late pregnancy?

1. AINR rises to about 3,0
2. BFibrinogen and D-dimer rise
3. CaPTT doubles from baseline
4. DPlatelets rise above 600 × 10³/µL

A patient with acute kidney injury after severe dehydration has a rising creatinine. Which urine findings support a prerenal cause rather than acute tubular necrosis (ATN)?

1. AWhite cell casts with positive nitrites on the dipstick
2. BLow urine sodium and concentrated urine with a high specific gravity
3. CRed cell casts with heavy protein loss in the urine
4. DHigh urine sodium and dilute urine with muddy brown granular casts

A patient receives IV furosemide for fluid overload. Which findings show the treatment is working?

1. AA rise in blood pressure and a new cough
2. BIncreased urine output, less breathlessness and a falling weight
3. CA rise in weight and more lung crackles
4. DFalling urine output, new ankle swelling and a rise in weight

During a blood transfusion, an older patient with heart failure becomes breathless with a rising blood pressure, raised JVP and crackles in the lungs. What is the most likely cause?

1. ATransfusion-associated circulatory overload
2. BAnaphylaxis
3. CTransfusion-related acute lung injury with hypotension
4. DA febrile non-haemolytic reaction

Jaka porada pomaga zapobiegać zakrzepicy żył głębokich podczas długiego lotu lub po operacji?

1. ANosić ciasne opaski elastyczne tuż poniżej kolana
2. BRegularnie ćwiczyć kostki i pić wystarczającą ilość płynów
3. CPić mniej, aby nie wstawać do toalety
4. DSiedzieć z nogami założonymi jedna na drugą dla wygody

A patient with a COPD exacerbation has been on NIV for two hours. They are now more drowsy, and the pH has fallen further despite a good mask fit. What should the nurse do?

1. AEscalate urgently for review of intubation or a ceiling of care
2. BContinue NIV unchanged and repeat the blood gas tomorrow morning
3. CRemove the mask and give nebulised bronchodilators only from now on
4. DGive a sedative to help the patient tolerate the mask

A patient who has had type 1 diabetes for 30 years says they no longer feel the warning signs of a hypo. What is this called?

1. ADiabetic ketoacidosis
2. BHypoglycaemia unawareness
3. CThe dawn phenomenon
4. DInsulin resistance

An 89-year-old with stage 5 CKD and severe heart failure, who has capacity, decides not to start dialysis. What is the nurse's best response?

1. AStop all care, because nothing more can be done
2. BRespect the decision and support symptom-focused care
3. CTell the patient they must start dialysis by law
4. DAsk the family to change the patient's mind

Which technique is correct when giving a prefilled low molecular weight heparin injection?

1. ALeave the air bubble in and inject into a skin fold
2. BRub the site firmly afterwards to help absorption
3. CExpel the air bubble first and inject into the deltoid muscle
4. DInject into a vein in the back of the hand

While a central line is disconnected, a patient suddenly becomes breathless with chest pain and hypotension. Air embolism is suspected. What should the nurse do first?

1. ASit the patient fully upright and flush the line
2. BRemove the central line straight away and leave the site open to the air
3. CGive the patient a drink and observe for an hour
4. DClamp the line, lie the patient left side down, head low; give oxygen