Priorytetyzacja i delegowanie w stylu NCLEX: zestaw na powtórkę

An arterial blood gas shows pH 7,28, PaCO₂ 40 mmHg (5,3 kPa) and HCO₃⁻ 16 mEq/L (mmol/L). How should the nurse interpret it?

1. ARespiratory acidosis
2. BRespiratory alkalosis
3. CMetabolic alkalosis
4. DMetabolic acidosis

Which assignment by the charge nurse should be changed?

1. AAn LPN/LVN is assigned to give oral medications to stable patients
2. BAn RN is assigned to a patient receiving a blood transfusion
3. CAn LPN/LVN is assigned to admit a new patient from the emergency department
4. DA nursing assistant is assigned to help several stable patients with their meals

A parent says, “I tell my son his medicine is candy so he takes it.” What should the nurse teach?

1. AThis is a good idea and makes giving medicine easier
2. BDo not call medicine candy, because the child may take it when no one is watching
3. CIt is fine as long as the medicine is kept in the fridge
4. DIt only matters for medicines that taste bitter or are hard to swallow

A patient’s allergy band says “penicillin”, and an order has been written for amoxicillin. What should the nurse do?

1. AGive the drug and watch the patient closely
2. BAsk the patient whether they would like to take it anyway
3. CHold the drug and contact the prescriber
4. DGive an antihistamine first and then the drug

A patient starts lisinopril (an ACE inhibitor). Which laboratory values should the nurse expect to be monitored?

1. ATSH and free T₄
2. BCalcium and phosphate
3. CPotassium and creatinine
4. DALT and bilirubin

A patient has painless jaundice, itching, dark urine and pale stools. ALP is markedly raised, conjugated (direct) bilirubin is high and ALT is only mildly raised. What is the most likely cause?

1. AAcute viral hepatitis with widespread liver cell damage
2. BBlockage of bile flow, for example by a tumor in the bile duct
3. CGilbert syndrome, a harmless inherited bilirubin disorder
4. DIncreased breakdown of red blood cells (hemolytic anemia)

Pacjent z cukrzycą typu 1 ma glikemię 25 mmol/L, głęboki szybki oddech i ciała ketonowe w moczu. Jakie jest prawdopodobne rozpoznanie?

1. ACukrzycowa kwasica ketonowa
2. BZespół hiperglikemiczno-hipermolalny bez ketonów
3. CPrawidłowe wahania glikemii
4. DHipoglikemia

Which feature best distinguishes delirium from dementia?

1. ADelirium starts suddenly and fluctuates, while dementia develops gradually
2. BDementia always causes visual hallucinations
3. CDelirium is permanent, while dementia is reversible
4. DDelirium only affects people under 50, while dementia affects older people

Why is a raised serum lactate concerning in a patient with shock?

1. AIt confirms a bacterial infection is present
2. BIt means the kidneys are working harder than normal to clear fluid
3. CIt suggests tissues are short of oxygen and using anaerobic metabolism
4. DIt shows only that the patient has eaten a large meal in the past hour

Pacjent z niewydolnością serca na ograniczeniu płynów do 1,5 L/dobę skarży się na silne pragnienie. Które działanie jest najodpowiedniejsze?

1. AHigiena jamy ustnej, liczone kostki lodu i płyny rozłożone na cały dzień
2. BCałkowity brak płynów do czasu porannego ważenia
3. CNieograniczona ilość wody, ponieważ pragnienie zawsze trzeba zaspokoić
4. DSłone przekąski pobudzające ślinę i łagodzące suchość

Why is an ACE inhibitor often given to a patient with diabetes and albumin in the urine?

1. AIt raises potassium to protect the heart
2. BIt lowers the blood glucose to normal
3. CIt protects the kidneys and reduces albumin loss
4. DIt stops the kidneys from passing so much urine at night

Pacjent hemodializowany pyta, dlaczego trzeba ograniczać płyny między sesjami. Które wyjaśnienie jest prawidłowe?

1. ADodatkowy płyn osłabia ścianę przetoki i zwiększa ryzyko jej pęknięcia
2. BOgraniczenie płynów służy głównie skróceniu czasu spędzanego przy aparacie
3. CNadmiar płynu gromadzi się, podnosząc ciśnienie i powodując duszność oraz skurcze podczas dializy
4. DPicie wody sprawia, że dializa usuwa zbyt dużo potasu z krwi

In the UK National Early Warning Score (NEWS2), what does an aggregate score of 5 or more usually trigger?

1. ADischarge planning for the next day
2. BAn urgent review by a clinician skilled in acute illness
3. CRoutine observations once every 12 hours, with no other change in care
4. DNo change unless the patient complains

A category (stage) 4 pressure ulcer is now healing and shallower. How should it be documented according to standard guidance?

1. AAs a category 2 pressure ulcer now
2. BAs a healing category 4 pressure ulcer
3. CAs a fully healed ulcer that can be removed from the record
4. DAs a category 1 pressure ulcer now