Priorytetyzacja i delegowanie w stylu NCLEX: zestaw na powtórkę

Which patient on an addiction unit should the nurse see first?

1. ALast drink one week ago; asking about support groups
2. BLast drink this morning; asking when lunch will arrive
3. CIn recovery for a year; came to the clinic today for a routine check and a repeat prescription
4. DLast drink two days ago; now shaking, sweating, heart rate 124/min and seeing insects

A patient on peritoneal dialysis has cloudy fluid draining out and abdominal pain. What does this most likely mean?

1. AA normal finding at the end of each exchange
2. BConstipation that will settle with a laxative later today or tomorrow
3. CToo much fluid left in the abdomen after the drain
4. DPeritonitis, which needs prompt reporting and a fluid sample

A nurse who wears prescription glasses must irrigate a wound where splashing is likely. Which eye protection is suitable?

1. AGoggles or a face shield worn over the glasses
2. BThe prescription glasses alone
3. CThe glasses with a surgical mask
4. DNo eye protection, if the nurse stands to one side

A patient dies after a wrong-drug error, and the hospital carries out a root cause analysis. What is its main focus?

1. AIdentifying which staff member made the error and should be disciplined
2. BEstimating the legal costs for the hospital
3. CFinding the system and process weaknesses that allowed the error
4. DDeciding whether to tell the family about the error

A patient with type 2 diabetes starts prednisone each morning. When is the glucose most likely to be highest?

1. AAt midnight only
2. BThe glucose will not change
3. CIn the early morning, before the dose
4. DIn the afternoon and evening

Który zestaw wyników jest najbardziej typowy dla niedokrwistości z niedoboru żelaza?

1. APrawidłowa hemoglobina wyłącznie z wysoką liczbą płytek
2. BNiska hemoglobina, duże krwinki czerwone (wysokie MCV) i wysoka ferrytyna
3. CWysoka hemoglobina i wysoki hematokryt
4. DNiska hemoglobina, małe krwinki czerwone (niskie MCV) i niska ferrytyna

Which advice should be given to a patient with a new permanent pacemaker?

1. ANever raise the arm on that side again
2. BAvoid using all household electrical appliances such as kettles
3. CStop all heart medicines straight away
4. DTell staff about the pacemaker before any MRI scan or procedure

A patient has a painful, punched-out ulcer on the toes, with a cold, pale foot and weak foot pulses. Which type of ulcer is most likely?

1. AAn arterial ulcer
2. BA venous ulcer
3. CA pressure ulcer from bed rest
4. DA burn

In heart failure, why does activation of the renin–angiotensin–aldosterone system worsen symptoms over time?

1. AIt causes sodium and water retention and vasoconstriction
2. BIt makes the kidneys pass too much dilute urine each day
3. CIt slows the heart rate dangerously
4. DIt lowers the blood pressure to very low levels over time

U pacjenta ze znaną chorobą tętnic obwodowych nagle pojawia się zimna, biała, bolesna stopa bez tętna i z drętwymi palcami. Co jest priorytetem?

1. AZachęcać do chodzenia, aby otworzyć krążenie oboczne
2. BZałożyć bandaż uciskowy w celu poprawy krążenia
3. CNatychmiast eskalować jako stan nagły; kończynę utrzymywać na poziomie, bez ciepła
4. DUnieść nogę na poduszkach i ogrzać stopę termoforem

Dlaczego po tyreoidektomii przy łóżku często trzyma się narzędzia do usuwania szwów lub klipsów?

1. ASłużą do regulacji drenu, gdy przestaje działać
2. BSą potrzebne do pobierania krwi z żył szyi
3. CKrwiak szyi może uciskać drogi oddechowe i może wymagać odbarczenia
4. DSzwy trzeba usunąć pierwszego wieczoru po operacji

A patient with a brain tumour on high-dose dexamethasone has a capillary glucose of 16 mmol/L (288 mg/dL). They have no history of diabetes. What is the best explanation?

1. AA sign that the brain tumour has now spread to the pancreas
2. BSteroid-induced hyperglycaemia, which needs monitoring and treatment
3. CNormal for this patient, so no action is needed
4. DA lab error, because steroids lower blood glucose

Which drug class is used to reduce the risk of a first variceal bleed in cirrhosis?

1. ANon-selective beta-blockers
2. BCalcium supplements
3. CThiazide diuretics
4. DProton pump inhibitors

After forearm fracture surgery, a patient has severe pain not eased by opioids, made worse by passively moving the fingers. What should the nurse do?

1. ARaise the arm as high as possible and give a further dose of opioid
2. BApply ice and a tighter bandage to reduce the swelling
3. CReassure the patient that this pain is expected
4. DLoosen any tight dressing, keep the arm at heart level and escalate