Priorytetyzacja i delegowanie w stylu NCLEX: zestaw na powtórkę

Which patient with diabetes should the nurse see first?

1. AHbA1c result of 8,2%, asking about diet
2. BGlucose 48 mg/dL (2,7 mmol/L), sweating and confused
3. CNeeds foot care teaching before discharge tomorrow
4. DGlucose 210 mg/dL (11,7 mmol/L) after a large lunch, feels well

After a vaginal birth, the uterus is firm and central, but bright red blood keeps trickling steadily. What should the nurse suspect?

1. AA tear in the birth canal or cervix
2. BUterine atony that needs more massage
3. CA full bladder pushing the uterus aside
4. DNormal lochia for the first hour

A patient has highly contagious viral conjunctivitis. Which teaching is most important?

1. ARub the eyes gently to remove the discharge
2. BKeep using the same contact lenses to protect the eyes
3. CWash hands often and do not share towels, pillows or eye drops
4. DWear a surgical mask whenever someone else is in the room

A nurse has worked three long shifts in a row and feels exhausted. The manager asks the nurse to stay for another shift. What is the most appropriate response?

1. AAgree and drink extra coffee to stay alert
2. BAgree without telling anyone about the fatigue
3. CExplain that fatigue would make care unsafe and decline the extra shift
4. DAgree, but skip the independent medication checks to save energy on the shift

A patient has taken hydrochlorothiazide for several years. Which laboratory change is a recognized effect of this drug?

1. AA rise in serum potassium
2. BA rise in serum uric acid
3. CA fall in serum calcium
4. DA fall in blood glucose

Pacjent z przewlekłą hiponatremią (sód 118 mEq/L) jest leczony. Dlaczego sód trzeba podnosić powoli?

1. ASzybka korekta powoduje hipokaliemię, która jest jedynym ryzykiem
2. BMoże to spowodować osmotyczną demielinizację, ciężkie uszkodzenie mózgu
3. CPowolna korekta jest potrzebna tylko po to, by obniżyć koszty hospitalizacji
4. DSzybka korekta sprawia, że sód znów spada jeszcze bardziej

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

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

Pacjent po operacji ma tętno 115/min, temperaturę 38,6 °C, częstość oddechów 26/min i ciśnienie 85/50 mmHg mimo bolusu płynów. Na co to najpewniej wskazuje?

1. APrawidłową reakcję zapalną w pierwszych dobach po operacji
2. BLęk przed wypisem
3. CWstrząs septyczny wymagający pilnej oceny przez zespół intensywnej terapii
4. DWyłącznie łagodne odwodnienie

A patient has a heart rate of 36/min with hypotension and dizziness. Which drug is usually the first choice?

1. AOral bisoprolol
2. BIntravenous atropine
3. CIntravenous adenosine
4. DIntravenous amiodarone

A patient with squamous cell lung cancer becomes confused, thirsty and constipated, with abdominal pain. Which electrolyte disturbance is most likely?

1. AHyponatraemia
2. BHypokalaemia
3. CHypercalcaemia
4. DHypomagnesaemia

A patient with untreated hyperthyroidism is losing weight. Which diet is most appropriate until the condition is controlled?

1. AA strict low-protein diet
2. BA high-calorie diet with enough protein
3. CA diet very high in caffeine for energy
4. DA low-calorie diet to protect the heart

Two days after an ileal conduit was formed, the stoma is dark purple and dry. What should the nurse do?

1. ARecord it as normal for a new stoma
2. BChange the bag and check again next week
3. CApply a warm compress to improve the colour of the stoma
4. DReport it urgently, because the stoma may be ischaemic

Which presentation fits acute diverticulitis?

1. ACentral chest pain spreading to the left arm
2. BLeft lower abdominal pain, fever and a raised CRP
3. CRight upper abdominal pain after fatty meals
4. DPainless jaundice with a palpable gallbladder

After a fall, a patient with advanced dementia is agitated, grimacing and guarding the hip, and cannot rate the pain. What should the nurse do?

1. AUse an observational pain tool, give analgesia and reassess
2. BWait until a relative can confirm the pain
3. CGive a sedative to treat the agitation and avoid giving any analgesia
4. DAssume there is no pain because none is reported