Priorytetyzacja i delegowanie w stylu NCLEX: zestaw na powtórkę

A patient taking clozapine reports a sore throat and fever. What is the priority action?

1. AOffer throat lozenges and continue the usual dose
2. BHold the dose and report so the white cell count can be checked
3. CAdvise the patient to gargle with warm salt water and rest in bed
4. DIncrease the dose because the symptoms suggest a relapse

Which patient needs airborne precautions rather than droplet precautions?

1. AA child with chickenpox (varicella)
2. BA child with pertussis (whooping cough)
3. CAn adult with influenza
4. DA teenager with mumps

A patient has leftover opioid tablets after surgery. Which advice about disposal is best?

1. AReturn them to a pharmacy or an approved take-back site
2. BLeave them in the bathroom cabinet indefinitely
3. CKeep them in an unlocked drawer at home in case of future pain
4. DGive them to a friend or relative who has back pain

U pacjenta stwierdzono MRSA w ranie i teraz wymaga zmiany opatrunku. Jakie środki ochrony indywidualnej są odpowiednie?

1. ABrak środków ochrony, jeśli ręce zostaną potem umyte
2. BWyłącznie rękawiczki jałowe, bez fartucha i innej ochrony
3. CFartuch i rękawiczki, a także ochrona oczu i maska, jeśli prawdopodobne jest rozpryskiwanie
4. DWyłącznie respirator N95, ponieważ MRSA jest drobnoustrojem opornym

A patient is on an IV insulin infusion protocol in the ICU. How often is the blood glucose usually checked?

1. AOnly if symptoms occur
2. BOnce every 12 hours
3. CAbout every hour
4. DOnce a day before breakfast

A 68-year-old man has fatigue, a hemoglobin of 9,8 g/dL (98 g/L), an MCV of 72 fL and a low ferritin. He eats a normal diet. What is the most important next step?

1. AGive iron and do no further tests at all
2. BStart vitamin B₁₂ injections
3. CRepeat the blood count in one year
4. DLook for a source of blood loss in the gut

How should a nurse communicate with a patient who has impaired hearing?

1. AShout loudly from the end of the bed so they can hear
2. BSpeak very quickly to save time
3. CFace the patient, speak clearly and reduce background noise
4. DTalk to the patient's relative instead of to the patient directly

A patient going home after chemotherapy is taught about infection. Which statement shows a need for further teaching?

1. A"I will phone the helpline if I have a fever or shivering."
2. B"If I get a temperature, I'll take paracetamol and wait until my next clinic."
3. C"I will check my temperature if I feel unwell or shivery at home."
4. D"I will wash my hands well before eating and after using the toilet."

A patient has chest pain at rest in the early morning with brief ST elevation that resolves. Coronary arteries are later found to be clear. Which condition is most likely?

1. AVasospastic (Prinzmetal) angina
2. BAcute pericarditis
3. CAortic stenosis
4. DStable exertional angina from a fixed plaque

Pacjent po wszczepieniu mechanicznej zastawki mitralnej, przyjmujący warfarynę, ma INR 2,2. Co powinna rozważyć pielęgniarka?

1. AINR przy zastawkach mechanicznych powinien wynosić około 1,0
2. BINR może być poniżej wyższej wartości docelowej tego pacjenta, więc należy to sprawdzić i zgłosić
3. CINR mieści się w zakresie dla każdego wskazania do warfaryny, więc nie trzeba nic robić
4. DINR jest niebezpiecznie wysoki i dawkę trzeba wstrzymać

A patient uses a continuous glucose monitor. Which statement is correct?

1. AIt measures glucose directly in the blood every second of the day
2. BIt makes finger-prick checks unnecessary in every situation
3. CIt reads glucose in fluid under the skin, a little behind blood glucose
4. DIt works by giving small doses of insulin automatically

A patient with known back pain says they now cannot feel the skin between their legs and have not passed urine for 12 hours. What should happen?

1. AAdvice to rest at home and take stronger painkillers
2. BA laxative and review in the clinic in a month
3. CA routine physiotherapy appointment next week
4. DUrgent MRI and referral to the spinal surgeons

Why is the "whoosh" test no longer used to check nasogastric tube position?

1. AIt needs an X-ray machine at the bedside
2. BThe air always makes the tube block
3. CThe test is far too painful for most patients to tolerate
4. DAir can be heard even when the tube is in the lung

U pacjenta z rakiem płuca pojawia się obrzęk twarzy, poszerzone żyły szyjne i duszność nasilająca się w pozycji leżącej. Jaki stan nagły jest prawdopodobny?

1. AHiperkalcemia w przebiegu nowotworu
2. BUcisk rdzenia kręgowego
3. CMasywna zatorowość płucna
4. DZespół żyły głównej górnej