Priorytetyzacja i delegowanie w stylu NCLEX: zestaw na powtórkę

A patient’s urinary catheter has drained no urine for two hours, and the lower abdomen is swollen. What should the nurse do first?

1. ARemove the catheter and wait for the patient to void
2. BEncourage the patient to drink more water
3. CCheck the tubing for kinks or obstruction
4. DGive a prescribed diuretic straight away

At the end of a shift, the nurse’s relief has not arrived and the patients are acutely ill. What should the nurse do?

1. AAsk a nursing assistant to watch the patients until someone comes
2. BLeave a written note at the station and go home
3. CStay and tell the charge nurse, and hand over before leaving
4. DLeave on time, because the shift has officially ended

A nurse’s hands are dry and cracked from frequent hand hygiene. What is the best approach?

1. AWear gloves all day instead of cleaning the hands between patients
2. BUse any lotion from home, whatever its contents
3. CStop hand hygiene until the skin heals
4. DUse the hand lotion approved by the facility to keep the skin intact

During flu season, a nurse wakes up with fever, cough and muscle aches. What is the best action?

1. AGo to work but avoid caring for patients who have weak immune systems
2. BTake an antipyretic so the fever does not show at work
3. CStay home and inform the employer according to the illness policy
4. DGo to work but wear a surgical mask for the whole shift

A patient with hyperkalemia is prescribed an oral potassium binder such as patiromer or sodium zirconium cyclosilicate. How does this drug lower potassium?

1. AIt protects the heart muscle against high potassium levels
2. BIt stops the kidneys from absorbing water in the tubules
3. CIt moves potassium into cells in the next few minutes
4. DIt binds potassium in the gut so it leaves in the stool

At the start of a shift, the nurse reviews four new results. Which patient needs attention first?

1. AHemoglobin 11,0 g/dL (110 g/L) in a patient with rheumatoid arthritis
2. BSodium 119 mEq/L in a patient with new confusion and vomiting
3. CPotassium 5,2 mEq/L in a patient with stable chronic kidney disease
4. DGlucose 180 mg/dL (10 mmol/L) after a meal in a patient with diabetes

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. BTalk to the patient's relative instead of to the patient directly
3. CFace the patient, speak clearly and reduce background noise
4. DSpeak very quickly to save time

A patient with metastatic breast cancer is confused and constipated, with a corrected calcium of 3,3 mmol/L (about 13,2 mg/dL). What is usually the first treatment?

1. AIV fluid rehydration, followed by a bisphosphonate
2. BA high-calcium diet
3. COral calcium supplements and vitamin D
4. DStrict fluid restriction to protect the kidneys

A patient in cardiac rehabilitation asks how hard to exercise. Which simple guide is commonly taught?

1. AExercise so they are a little breathless but can still talk
2. BExercise until chest pain starts, then stop
3. CExercise until they are too breathless to speak at all
4. DExercise only until the heart rate rises even slightly

An older patient with three rib fractures is breathing shallowly and refuses to cough because of pain. What is the priority intervention?

1. AStrap the chest tightly with bandages to stop the ribs moving
2. BEffective analgesia so they can breathe deeply and cough
3. CKeep the patient flat and still in bed until the pain settles
4. DWithhold analgesia to avoid depressing breathing

A patient takes an SGLT2 inhibitor. Which sick-day advice is correct?

1. ADouble the dose during illness to control the glucose
2. BStop drinking fluids while taking the drug
3. CKeep taking it as normal, whatever the illness
4. DPause the drug during illness with vomiting or poor intake

A patient arrives five hours after the onset of a stroke. A CT angiogram shows a blockage of a large artery in the brain. What is the most appropriate next step?

1. AUrgent referral for assessment for mechanical thrombectomy
2. BStart IV alteplase immediately without further imaging
3. CNo treatment, because the time for any reperfusion has passed
4. DGive aspirin and plan a review on the ward tomorrow

Pacjent z marskością przyjmuje laktulozę z powodu encefalopatii wątrobowej. Jaki jest zwykły cel?

1. ABrak wypróżnienia przez kilka dni
2. BDziesięć lub więcej wodnistych stolców dziennie
3. CJeden twardy stolec tygodniowo
4. DDwa do trzech miękkich stolców dziennie

After two days of large volumes of IV 5% glucose, a postoperative patient becomes confused with a headache. Sodium is 124 mmol/L. What is the likely cause?

1. AHypoglycaemia from the glucose
2. BNormal confusion after any anaesthetic
3. CHyponatraemia from hypotonic fluids
4. DHypernatraemia from too much salt