Priorytetyzacja i delegowanie w stylu NCLEX: zestaw na powtórkę

The day after a total thyroidectomy, a patient reports tingling around the mouth and in the fingers. What should the nurse do first?

1. AGive the patient’s routine oral iron supplement early
2. BCheck for signs of low calcium and inform the provider
3. CReassure the patient that this is normal after neck surgery
4. DEncourage deep breaths into a paper bag until it passes

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

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

A patient has received oral radioactive iodine therapy. Which precaution is usually taken?

1. AEncourage pregnant visitors to sit close to the patient to give emotional support
2. BPlace the patient on droplet precautions with a surgical mask
3. CLet the patient share a bathroom with other patients
4. DLimit time close to the patient and handle body fluids per radiation policy

A nurse has worked three long shifts in a row and feels exhausted. The manager asks the nurse to stay for another shift. What is the most appropriate response?

1. AAgree without telling anyone about the fatigue
2. BAgree and drink extra coffee to stay alert
3. CAgree, but skip the independent medication checks to save energy on the shift
4. DExplain that fatigue would make care unsafe and decline the extra shift

A patient has a calcium of 11,8 mg/dL (2,95 mmol/L) from bone metastases. Which nursing measure is appropriate?

1. AEncourage bed rest and limit oral fluids
2. BEncourage fluids and mobility as tolerated
3. COffer extra milk and cheese at each meal
4. DGive calcium carbonate antacids for nausea

A patient has a hemoglobin of 11,2 g/dL (112 g/L), an MCV of 64 fL, a normal ferritin and a normal-to-high red cell count. What is the most likely cause?

1. AThalassemia trait
2. BAcute blood loss
3. CIron deficiency
4. DVitamin B₁₂ deficiency

Which rule is essential for safe use of patient-controlled analgesia (PCA)?

1. AThe nurse should press it every hour
2. BRelatives should press it while the patient sleeps
3. CThe button should be pressed before each meal
4. DOnly the patient should press the button

Starszy pacjent nagle w nocy staje się splątany, z wahaniami uwagi. Jaką przyczynę należy zbadać najpierw?

1. ANagły początek choroby Alzheimera
2. BPrawidłowe starzenie się
3. CMajaczenie spowodowane chorobą podstawową, np. zakażeniem lub lekiem
4. DBrak zainteresowania otoczeniem

A patient who had a stroke has a weak swallow. Which measure most reduces the risk of aspiration pneumonia?

1. ALying flat for 30 minutes after eating to aid digestion
2. BGiving meals while the patient is drowsy
3. CGiving thin fluids quickly through a straw between meals
4. DA swallowing assessment and sitting upright for meals

Jakie podejście do usuwania drenu klatki piersiowej jest powszechnie nauczane?

1. AUsunąć go i pozostawić miejsce otwarte, aby drenowało przez dobę
2. BUsuwać go powoli, gdy pacjent bierze długi, głęboki wdech
3. CUsunąć go podczas zatrzymanego oddechu lub w wydechu, a następnie uszczelnić miejsce
4. DUsunąć go przy nadal działającym ssaniu na pełnej mocy

A patient has acute low back pain with no red flags. Which advice is most appropriate?

1. AAvoid all movement until an MRI scan has been done
2. BWear a rigid back brace all day and night for at least three months
3. CStay as active as possible and use simple pain relief
4. DStay in bed for two weeks until the pain is gone

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

1. AToo much vitamin D from supplements
2. BSecondary hyperparathyroidism from CKD
3. CHypoparathyroidism after neck surgery
4. DPrimary hyperparathyroidism from a tumour

Jaka skala służy do oceny ryzyka w krwawieniu z górnego odcinka przewodu pokarmowego przed endoskopią?

1. ASkala Wellsa dla zakrzepicy żył głębokich
2. BSkala śpiączki Glasgow
3. CSkala ryzyka odleżyn Waterlow
4. DSkala Glasgow-Blatchford

A patient is booked for a urea breath test for H. pylori. Which medicine should usually be stopped 2 weeks before the test?

1. AAmlodipine
2. BOmeprazole
3. CLevothyroxine
4. DParacetamol (acetaminophen)