Priorytetyzacja i delegowanie w stylu NCLEX: zestaw na powtórkę

A patient receives hemodialysis this morning. Which type of medication is often held before dialysis, as prescribed?

1. AEye drops for glaucoma
2. BAntihypertensive drugs
3. CTopical skin creams
4. DInhaled bronchodilators

After a head injury, a patient passes large amounts of very dilute urine, is thirsty and has a rising serum sodium. Which condition is most likely?

1. AAcute kidney injury with oliguria
2. BDiabetes insipidus
3. CSIADH
4. DDiabetic ketoacidosis

A newly hired nurse had BCG vaccine as a child. Which TB screening test is usually preferred?

1. ANo screening, because BCG prevents all TB
2. BAn interferon-gamma release assay (IGRA) blood test
3. CA chest x-ray every month for the first year
4. DA tuberculin skin test, which is read 24 hours after it is placed

A patient with depression has suddenly become calm and is giving away personal possessions. What does this suggest?

1. AThat the patient wants to make new friends on the unit
2. BA possibly increased suicide risk that needs immediate assessment
3. CThat the patient is now ready for discharge today
4. DThat the depression has resolved and observation can be reduced

Which IV fluid can be given through the same line as a red cell transfusion?

1. A0,45% sodium chloride
2. B5% dextrose in water
3. CLactated Ringer's (Hartmann's) solution
4. D0,9% sodium chloride

A patient has fever, confusion, a platelet count of 15 × 10³/µL, anemia with fragmented red cells (schistocytes) and a raised creatinine. Clotting times are normal. Which condition should be suspected?

1. ADisseminated intravascular coagulation
2. BImmune thrombocytopenia (ITP)
3. CVitamin K deficiency with bleeding
4. DThrombotic thrombocytopenic purpura (TTP)

Modern wound care generally aims to keep a healing wound bed:

1. AMoist but not wet
2. BSoaked in antiseptic solution every day
3. CCompletely dry and open to the air
4. DTightly packed with dry gauze

A patient suddenly develops a painful red eye with blurred vision, haloes around lights and vomiting. What should be suspected?

1. ASimple conjunctivitis from a viral infection
2. BAcute angle-closure glaucoma
3. CA stye
4. DDry eye syndrome

The telemetry monitor suddenly shows a chaotic waveform resembling ventricular fibrillation, but the patient is talking and brushing their teeth. What should the nurse do first?

1. AGive IV amiodarone as a bolus
2. BCheck the patient and the electrodes, as this is likely artefact
3. CDeliver an immediate defibrillation shock before checking anything
4. DStart chest compressions straight away and call the arrest team

After intubation, breath sounds are heard on the right side of the chest but not the left. What is the most likely cause?

1. AThe tube cuff has burst during insertion
2. BThe tube has entered the right main bronchus
3. CThe tube has entered the oesophagus
4. DThe left lung has completely filled with fluid

Which blood gas pattern is typical of acute kidney injury?

1. ALow pH and high carbon dioxide only
2. BHigh pH and high bicarbonate
3. CHigh pH and low carbon dioxide
4. DLow pH and low bicarbonate

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. AOral antibiotics and waiting for the stone to pass
2. BUrgent drainage of the kidney plus IV antibiotics
3. CA fluid restriction to reduce the swelling
4. DStrong pain relief alone, then discharge

What is the most important safety point about misoprostol?

1. AIt must be given only by deep intramuscular injection
2. BIt strongly raises blood glucose in people with diabetes
3. CIt causes severe constipation in most patients
4. DIt can cause miscarriage and must not be used in pregnancy

Jaką strategię płynową zasadniczo zaleca się w pierwszych godzinach ostrego zapalenia trzustki?

1. AUkierunkowane na cel zbilansowane krystaloidy, dostosowywane do odpowiedzi
2. BDożylna albumina zamiast jakichkolwiek krystaloidów
3. CBrak płynów dożylnych, tylko małe łyki wody doustnie
4. DBardzo duże objętości, niezależnie od odpowiedzi pacjenta