Priorytetyzacja i delegowanie w stylu NCLEX: zestaw na powtórkę

A patient with schizophrenia says voices are telling him to hurt his roommate. What is the priority?

1. AKeep everyone safe and tell the team, as the risk of harm is high
2. BTell him the voices are not real and leave him alone
3. CAsk the roommate to stay in the room with him and help calm him down
4. DIgnore the comment, because voices are part of his illness

Which assignment by the charge nurse should be changed?

1. AA nursing assistant is assigned to help several stable patients with their meals
2. BAn LPN/LVN is assigned to admit a new patient from the emergency department
3. CAn RN is assigned to a patient receiving a blood transfusion
4. DAn LPN/LVN is assigned to give oral medications to stable patients

A patient receiving continuous nasogastric feeding has pulled the tube partly out. What should the nurse do first?

1. AStop the feeding until the tube position is checked
2. BTape the tube in its new position and continue
3. CPush the tube back in and restart the feed
4. DIncrease the feed rate to make up for the lost time

A nurse has a needlestick from a patient known to have hepatitis C. Which statement about management is correct?

1. AHepatitis C immune globulin is given within 24 hours, followed by a booster dose
2. BNo follow-up is needed because hepatitis C does not spread by needles
3. CThere is no preventive drug, so baseline and follow-up testing are done to detect infection early
4. DThe hepatitis C vaccine series is started at once, with a booster dose six months later

A patient starts high-dose prednisone. Which laboratory change should the nurse expect?

1. AA fall in serum sodium
2. BA rise in blood glucose
3. CA fall in the white cell count
4. DA rise in serum potassium

A patient taking an SGLT2 inhibitor has nausea and fast breathing. Glucose 190 mg/dL (10,5 mmol/L), pH 7,15, bicarbonate 10 mEq/L, blood ketones high. What is the most likely diagnosis?

1. AHyperosmolar hyperglycemic state
2. BEuglycemic diabetic ketoacidosis
3. CRespiratory acidosis from COPD
4. DSimple fasting ketosis only

Jakie jest leczenie farmakologiczne pierwszego rzutu w anafilaksji?

1. AParacetamol dożylnie
2. BDoustny lek przeciwhistaminowy, taki jak cetyryzyna
3. CAdrenalina domięśniowo
4. DWziewny glikokortykosteroid

A nurse teaches a patient with asthma about a new inhaled steroid "preventer". Which statement shows a need for further teaching?

1. A"I will rinse my mouth after using it."
2. B"I'll keep my reliever inhaler with me."
3. C"I will only use it when I'm wheezy."
4. D"I will use it every day even when I feel well."

Why should a long-acting beta-2 agonist (LABA) never be used alone in asthma?

1. AIt works only when it is taken together with a course of antibiotics
2. BIt cannot be inhaled without a nebuliser
3. CWithout an inhaled steroid, it is linked with severe and fatal attacks
4. DIt always causes immediate severe bronchospasm when used on its own

Godzinę po operacji kardiochirurgicznej dren śródpiersiowy odprowadził 350 mL jasnoczerwonej krwi, a częstość serca rośnie. Co powinna zrobić pielęgniarka?

1. AMocno wyciskać przewód co pięć minut
2. BZapisać objętość i kontynuować kontrole co godzinę
3. CNatychmiast zgłosić zespołowi chirurgicznemu
4. DZacisnąć dren, aby zatrzymać dalszą utratę krwi

A stroke patient with dysphagia has been started on a modified diet. Which action best reduces the risk of aspiration?

1. ASit the patient fully upright for meals and for a while afterwards
2. BGive fluids through a straw so they flow more slowly
3. CFeed quickly so the patient does not tire during the meal
4. DLay the patient flat straight after meals so they can rest and digest

Weeks after starting insulin, a patient with newly diagnosed type 1 diabetes needs much less insulin and has frequent mild hypos. What is the most likely explanation?

1. AA honeymoon phase, but insulin is still needed
2. BThe patient actually has type 2 diabetes
3. CThe insulin has gone off and should be replaced
4. DThe diabetes has been cured, so insulin can stop

Które stwierdzenie dotyczące żywienia w łagodnym ostrym zapaleniu trzustki zgadza się z aktualnymi zaleceniami?

1. AJedzenie wstrzymuje się do czasu normalizacji amylazy
2. BPacjentów należy żywić wyłącznie pozajelitowo
3. CŻywienie doustne można wznowić wcześnie, gdy ból i nudności na to pozwalają
4. DPacjenci muszą pozostawać na czczo co najmniej trzy tygodnie, aby oszczędzić trzustkę

A nurse teaches a patient with GORD. Which statement shows a need for further teaching?

1. A"I'll try to lose some weight over the next months."
2. B"I'll stop smoking because it makes reflux worse."
3. C"I'll keep a diary of foods that trigger my symptoms."
4. D"Peppermint tea after dinner will settle my reflux."