Priorytetyzacja i delegowanie w stylu NCLEX: zestaw na powtórkę

Which finding is an early sign of compartment syndrome in a patient with a lower leg fracture?

1. AItching under the cast during the first week after it was applied
2. BPain out of proportion to the injury that worsens when the toes are stretched
3. CMild bruising around the fracture site on the second day
4. DA strong pedal pulse with warm, pink toes and pain that settles with analgesia

Using ESI, a stable adult with abdominal pain will need blood tests and a CT scan, but has a heart rate of 130/min. Which statement is correct?

1. AVital signs never change the ESI level
2. BThe patient is level 4 because the blood tests and the scan count as one resource
3. CThe patient is level 5 because the pain is not severe
4. DThe nurse should consider level 2 because of the danger-zone vital sign

Which IV fluid can be given with packed red blood cells in the same line?

1. A5% dextrose in water
2. B5% dextrose in 0,45% sodium chloride
3. C0,9% sodium chloride
4. DLactated Ringer’s (Hartmann’s) solution

A nurse asks a colleague to “just glance” at an insulin infusion before starting it. What makes a check truly independent?

1. AThe second nurse looks at the bag label from the doorway
2. BThe second nurse signs the record after the infusion has already been started by the first
3. CThe second nurse checks the order, drug, dose and pump settings separately without being told the answer
4. DThe first nurse reads the details aloud and the second agrees

A patient's eGFR has fallen to 24 mL/min/1,73 m². Which prescribed drug should the nurse question before giving it?

1. ALevothyroxine
2. BAcetaminophen (paracetamol)
3. CMetformin
4. DInsulin glargine

Stężenie litu 1,0 mEq/L oznaczono 2 godziny po porannej dawce pacjenta, a lekarz planuje zwiększyć dawkę. Na co powinna zwrócić uwagę pielęgniarka?

1. AStężenie litu można oznaczać o dowolnej porze dnia bez wpływu na wynik
2. BStężenie jest za niskie, więc duże zwiększenie dawki jest ewidentnie bezpieczne
3. CPróbkę pobrano zbyt wcześnie po dawce, więc nie jest to wiarygodne stężenie
4. DStężenie jest toksyczne, więc lit należy odstawić na stałe

An arterial blood gas shows a low pH, a high PaCO₂ and a normal bicarbonate. What does this show?

1. ARespiratory alkalosis
2. BMetabolic acidosis
3. CRespiratory acidosis
4. DMetabolic alkalosis

Which sign is often a late finding in hypovolaemic shock in a young, previously fit adult?

1. AA rise in heart rate
2. BA slightly raised respiratory rate
3. CA fall in blood pressure
4. DCool peripheries

A patient with heart failure takes furosemide once a day. When is the best time to take it?

1. AWhenever the ankles look swollen, on those days only
2. BIn the morning, to avoid needing the toilet at night
3. CAt bedtime, so the effect lasts through the night
4. DJust before the evening meal, with a large drink

82-letni pacjent z pozaszpitalnym zapaleniem płuc jest od niedawna splątany, ma częstość oddechów 32/min, ciśnienie 88/52 mmHg i mocznik 9 mmol/L. Co to wskazuje?

1. AWynik CURB-65 równy 3: wyłącznie rutynowe przyjęcie na oddział ogólny
2. BPrawidłową reakcję na zakażenie u osoby starszej
3. CWynik CURB-65 równy 5: wysokie ryzyko wymagające pilnej oceny starszego lekarza
4. DWynik CURB-65 równy 1: nadaje się do doustnych antybiotyków w domu

Why must Parkinson's medicines be given on time in hospital?

1. ALate doses cause the patient to develop high blood glucose
2. BGiving them on time prevents the disease from getting worse
3. CLate doses build up in the blood and cause an overdose
4. DLate doses can soon cause stiffness, falls and poor swallowing

Który z tych pacjentów z ostrym udarem niedokrwiennym najmniej prawdopodobnie kwalifikuje się do dożylnej trombolizy?

1. APacjent, którego ciśnienie krwi wynosi 170/95 mmHg
2. BPacjent, który pięć dni temu przeszedł dużą operację jamy brzusznej
3. CPacjent, u którego objawy rozpoczęły się 90 minut temu
4. DPacjent, u którego TK nie wykazuje żadnych oznak krwawienia śródczaszkowego

A patient with obstructive sleep apnoea is admitted for surgery. Which instruction is most appropriate?

1. ABring their CPAP machine to use after surgery
2. BLie flat on their back for the first night
3. CStop all pain relief for the first three days
4. DAvoid sleeping at all on the night after surgery

A colleague suggests giving a saline injection to see whether a patient's pain is "real". What is the best response?

1. AIt is acceptable if a senior nurse gives the saline
2. BDeceptive placebos are unethical and do not show pain is "fake"
3. CIt should be done only for patients with chronic pain
4. DIt is a good idea, as long as the patient is not told about it afterwards