Priorytetyzacja i delegowanie w stylu NCLEX: zestaw na powtórkę

An older patient becomes confused over a few hours, with attention that comes and goes. What does this suggest?

1. ADelirium, which needs the cause found quickly
2. BNormal aging that needs no action
3. CA personality change that is permanent and expected
4. DLong-standing dementia that is expected

Podczas ciągłego żywienia przez zgłębnik pacjent nagle zaczyna kaszleć, ma duszność, a SpO₂ spada. Jakie jest pierwsze działanie pielęgniarki?

1. APrzepłukać zgłębnik 50 mL wody, a następnie kontynuować żywienie jak poprzednio
2. BZwiększyć szybkość żywienia, aby skończyło się szybciej
3. CUłożyć pacjenta płasko, aby odpoczął
4. DZatrzymać żywienie, posadzić pacjenta w pozycji pionowej i ocenić oddychanie

Why should a child’s weight be recorded only in kilograms?

1. AScales that show kilograms are always more accurate than those that show pounds
2. BKilograms are easier for parents to remember
3. CMixing up pounds and kilograms can lead to large dosing errors
4. DChildren weigh less, so smaller units are needed

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

Pacjent, który wymiotuje od dwóch dni, ma BUN 32 mg/dL (mocznik 11,4 mmol/L) i prawidłową kreatyninę. Jaka jest najbardziej prawdopodobna przyczyna?

1. ADieta niskobiałkowa
2. BPrzewodnienie
3. CNiewydolność wątroby
4. DOdwodnienie

A patient with a serum albumin of 1,9 g/dL (19 g/L) has signs of phenytoin toxicity, although the total phenytoin level is in the usual range. What is the most likely explanation?

1. ALow albumin stops phenytoin from crossing into the brain
2. BLow albumin makes the liver clear phenytoin much faster
3. CLow albumin raises the free (active) fraction of phenytoin
4. DLow albumin makes the total level falsely high in all cases

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

1. AMetabolic acidosis
2. BRespiratory acidosis
3. CMetabolic alkalosis
4. DRespiratory alkalosis

A patient has a high fever with rigors, jaundice and right upper quadrant pain. Which condition is most likely?

1. AAcute appendicitis
2. BGastro-oesophageal reflux disease
3. CAscending cholangitis
4. DSimple biliary colic

Which investigation is most often used to confirm a pulmonary embolism?

1. AAbdominal ultrasound
2. BSputum culture
3. CPeak flow measurement
4. DCT pulmonary angiography

An older patient's varicose vein bursts at the ankle and bleeds heavily. What is the most effective first aid?

1. ALie the patient down, raise the leg and press firmly on the site
2. BKeep the leg hanging down over the bed
3. CApply a hot compress to the leg to help the vein close up
4. DStand the patient up so the blood flows away and clots faster

Which measure best detects a decline in breathing in a patient with Guillain–Barré syndrome?

1. ADaily chest X-rays
2. BOxygen saturation alone
3. CPeak flow before and after a bronchodilator
4. DRegular forced vital capacity measurements

A nurse teaches a patient with CKD and a high potassium about diet. Which statement shows a need for further teaching?

1. A"I will boil my potatoes and throw away the water."
2. B"I will check food labels for added salt when I go shopping."
3. C"I will keep bananas and dried fruit to a minimum."
4. D"I will use a salt substitute instead of ordinary salt."

When is cold therapy most useful for pain?

1. ASoon after an acute soft tissue injury, to reduce swelling
2. BFor long-term muscle stiffness, applied continuously for several hours
3. COver numb areas where sensation is lost
4. DDirectly on skin with poor circulation

A 60 kg adult with 25% TBSA burns arrives 2 hours after the injury, having had no IV fluids. Using the Parkland formula, what hourly rate is needed for the rest of the first 8 hours?

1. A500 mL/h
2. B1000 mL/h
3. C250 mL/h
4. D375 mL/h