Priorytetyzacja i delegowanie w stylu NCLEX: zestaw na powtórkę

A patient with asthma uses a peak flow meter. A reading below 50% of personal best is in the red zone. Which statement shows correct understanding?

1. A“I will wait until tomorrow morning to see if the reading gets better on its own.”
2. B“I will go for a short run to open up my lungs.”
3. C“I will stop all my inhalers until the reading is back up.”
4. D“I will use my reliever inhaler and get emergency help straight away.”

Pacjent z cewnikiem centralnym nagle odczuwa duszność, ból w klatce piersiowej i spadek SpO₂ podczas usuwania cewnika. Co robi pielęgniarka w pierwszej kolejności?

1. APrzepłukuje cewnik solą fizjologiczną, aby usunąć ewentualną niedrożność
2. BProsi pacjenta o wolne, głębokie oddechy i kontynuuje
3. CZakrywa miejsce wkłucia, układa pacjenta na lewym boku z głową w dół, podaje tlen i wzywa pomoc
4. DSadza pacjenta w pozycji pionowej i szybko kończy usuwanie cewnika

Before inserting a peripheral IV, the nurse cleans the skin with chlorhexidine-alcohol. What should the nurse do next?

1. AWipe it off with a dry gauze straight away
2. BFeel for the vein again with an ungloved finger
3. CBlow on the site so it dries faster
4. DLet it dry fully and do not touch the site again

A nurse finds that a patient has been taking their own sleeping pills from a bedside drawer while also receiving a hypnotic from the ward. What should the nurse do?

1. ASecure the home medication per policy and inform the provider
2. BLet the patient keep them, since they are the patient’s own
3. CStop giving the hospital hypnotic without telling the provider or the pharmacy
4. DThrow the patient’s pills away in the bin

When should a blood specimen tube be labeled?

1. AIn the laboratory, by the staff who receive the unlabeled sample
2. BBefore entering the room, so tubes are ready for the next patients
3. CAt the bedside, in the patient's presence, using two identifiers
4. DAt the nurses' station, after all samples for the shift are drawn

Two sets of blood cultures were taken from separate sites. Only one bottle in one set grows coagulase-negative staphylococci, and the patient has no line or implant. What is the most likely interpretation?

1. ACertain bloodstream infection needing treatment
2. BProbable skin contamination of the sample
3. CProof that the patient has infective endocarditis
4. DInfection with a resistant organism such as MRSA

A nurse gives a patient analgesia for post-operative pain. What should be done next?

1. AAssume the pain has gone if the patient is quiet and has their eyes closed
2. BWait until the next shift before asking the patient about the pain
3. CGive a second analgesic straight away just in case
4. DReassess the pain and any side effects once the drug has had time to work

Why must a unit of red cells be transfused within the set time limit (commonly four hours) after it leaves controlled cold storage?

1. ABacteria can grow in the blood at room temperature
2. BThe bag stops dripping after four hours
3. CThe red cells break down and turn into plasma
4. DThe blood group of the cells changes after a few hours

A patient with angle-closure glaucoma needs nebulised ipratropium. What precaution is sensible?

1. AGive it only with the patient lying completely flat
2. BUse a mouthpiece or protect the eyes from the mist
3. CMix it with an eye drop before putting it in the nebuliser
4. DRun it at the highest possible gas flow

A patient has new chest pain at rest. The ECG shows ST depression, but serial troponins remain normal. Which diagnosis fits best?

1. ANon-ST-elevation myocardial infarction
2. BST-elevation myocardial infarction
3. CUnstable angina
4. DStable angina

Why should long-term steroid treatment not be stopped suddenly?

1. AThe suppressed adrenal glands cannot make enough cortisol at once
2. BStopping suddenly makes the bones grow too quickly and then fracture
3. CStopping causes the blood glucose to fall sharply
4. DThe steroids build up and become toxic after they are stopped

A patient taking an SGLT2 inhibitor is booked for major surgery. Which statement is correct?

1. AThe drug must be taken right up until the operation starts
2. BThe dose is usually doubled on the morning of surgery
3. CSurgery is not possible in patients taking this drug
4. DIt is usually paused in the days before surgery

After laparoscopic cholecystectomy, a patient has pain in the right shoulder. What is the most likely cause?

1. AAn allergy to the dressing on the wound
2. BA heart attack during the operation
3. CGas used during surgery irritating the diaphragm
4. DA dislocated shoulder from patient positioning

During a nasogastric feed, a patient starts coughing and SpO₂ falls from 96% to 89%. What should the nurse do first?

1. AIncrease the feed rate to finish it sooner
2. BGive a drink of water to clear the throat
3. CStop the feed and assess the airway and breathing
4. DLay the patient flat to help them rest