Priorytetyzacja i delegowanie w stylu NCLEX: zestaw na powtórkę

Several patients on a gastroenterology unit need care. Which patient should the nurse see first?

1. AUlcerative colitis, asking about diet changes for home
2. BTwo hours after a colonoscopy: rigid abdomen and severe new pain
3. CLong-standing back pain, asking for the usual analgesic
4. DCrohn disease, waiting to be taken down for a scheduled CT scan

An adult has burns over 40% of the body with no signs of airway injury. Which treatment is the priority during the first hours?

1. ALarge-volume IV fluids with close monitoring of urine output
2. BApplying antibiotic cream to all the burns before anything else
3. CGiving a high-protein meal to support healing
4. DStarting physiotherapy to prevent contractures straight away

A child has swallowed a button battery. Why is this urgent?

1. AIt always passes through the gut without harm
2. BIt is only harmful if several batteries are swallowed
3. CIt can burn through the lining of the esophagus within hours
4. DThe only risk is poisoning from heavy metals years later

A patient given naloxone for an opioid overdose wakes up. An hour later, the patient is drowsy again with slow breathing. What is the likely reason?

1. ANaloxone itself causes slow breathing and drowsiness once it has been given
2. BNaloxone wears off sooner than many opioids, so the opioid effect returns
3. CThe patient is simply tired after the event
4. DThe patient is now allergic to naloxone

Która zmiana w EKG wiąże się z hipokalcemią?

1. AWydłużony odstęp QT
2. BWysokie, szpiczaste załamki T
3. CWyraźna fala delta
4. DSkrócony odstęp QT

A patient has a sodium of 150 mEq/L, a glucose of 180 mg/dL and a BUN of 28 mg/dL. Using the formula 2 × Na + glucose/18 + BUN/2,8, what is the calculated serum osmolality?

1. AAbout 320 mOsm/kg, which is high
2. BAbout 300 mOsm/kg, which is normal
3. CAbout 358 mOsm/kg, which is high
4. DAbout 285 mOsm/kg, which is normal

Why is blood pressure monitored closely in a patient with an epidural infusion?

1. AEpidurals always cause severe hypertension that needs regular treatment
2. BBlood pressure readings show whether the catheter is infected
3. CThe local anaesthetic can block sympathetic nerves and cause hypotension
4. DThe epidural pump uses the blood pressure to set the rate

A patient starting a DOAC is taught about missed doses. Which statement shows a need for further teaching?

1. A"I will take it at the same time each day."
2. B"I will tell other doctors and my dentist I take an anticoagulant."
3. C"I will report any blood in my urine."
4. D"If I forget a dose, I'll take two the next day to catch up."

Rheumatic heart disease most often follows which infection?

1. AA viral infection of the upper airway
2. BA group A streptococcal throat infection
3. CStaphylococcal infection of the skin
4. DA fungal infection of the lungs

A nurse finds a patient collapsed in bed and unresponsive. What should the nurse do first?

1. AShout for help, open the airway and check breathing for up to 10 seconds
2. BLeave the patient to fetch a defibrillator before calling anyone
3. CTake a full set of observations, including temperature and blood glucose
4. DGive two rescue breaths, then check the blood glucose before calling anyone

After transsphenoidal pituitary surgery, which advice should the patient follow?

1. AAvoid blowing the nose, straining and bending forward
2. BLie completely flat for at least a week after surgery
3. CDrink through a straw to keep the nose clean
4. DBlow the nose often to clear any clots

An older man was found on the floor after lying there for many hours. His urine is dark brown, and his creatine kinase is very high. What is the main kidney risk and the key treatment?

1. AAKI from rhabdomyolysis, treated with generous IV fluids
2. BA urinary infection, treated with oral antibiotics only
3. CA kidney stone, treated with strong pain relief
4. DHypothermia, treated with a fluid restriction

Which finding suggests a deep tissue pressure injury?

1. APale pink skin that blanches quickly when pressed
2. BA small scratch on the skin with a little fresh red blood
3. CIntact skin that is purple or maroon over a bony area
4. DDry, flaky skin on both shins

Kilka godzin po usunięciu cewnika zewnątrzoponowego u pacjenta przyjmującego lek przeciwzakrzepowy pojawia się ból pleców i narastające osłabienie nóg. Co należy podejrzewać?

1. AOdleżynę krzyżową powodującą rzutowany ból nóg
2. BZakażenie układu moczowego powodujące ból pleców
3. CKrwiak zewnątrzoponowy, wymagający pilnej oceny i rezonansu magnetycznego
4. DPrawidłowe ustępowanie blokady zewnątrzoponowej w ciągu dnia