Priorytetyzacja i delegowanie w stylu NCLEX: zestaw na powtórkę

When making patient assignments, what should the charge nurse consider first?

1. AMatching each patient’s needs to staff competence
2. BGiving each nurse patients in rooms next to each other
3. CGiving the newest staff the most complex patients
4. DLetting staff choose the patients they prefer

Four patients arrive at the emergency department at the same time. Who should be seen first?

1. AA child with a temperature of 39 °C who is alert and drinking
2. BAn older adult with weakness on one side that began 40 minutes ago
3. CAn adult with kidney stone pain of 9/10 and stable vital signs
4. DA young adult with a swollen, painful ankle after a fall on the stairs

After teaching a patient about a new medication, how does the nurse best check understanding?

1. AGive a printed leaflet about the drug and assume the patient will read it at home
2. BAsk the family whether they understood the teaching
3. CAsk “Do you understand?” and accept a yes
4. DAsk the patient to explain in their own words how and when to take it

During bedside handoff, the patient says, “I’m allergic to sulfa drugs,” but no allergy is recorded. What should the nurse do?

1. AIgnore it, because the electronic record is more reliable than the patient’s memory
2. BTell the patient that sulfa drugs are always safe
3. CClarify the reaction, update the allergy record and tell the prescriber
4. DWait until the patient is discharged to update the record

How does normal pregnancy usually affect serum creatinine?

1. AIt falls, because GFR rises
2. BIt rises with every week
3. CIt rises, because GFR falls
4. DIt stays exactly the same

A patient with acute pancreatitis has a rising BUN, a falling calcium and a glucose of 250 mg/dL (13,9 mmol/L) over the first 48 hours. What do these results suggest?

1. AA lab error from lipemic samples
2. BA resolving, mild pancreatitis
3. CAn unrelated new kidney stone
4. DIncreasingly severe pancreatitis

Pacjent po wypadku drogowym ma ciężką duszność, brak szmeru oddechowego po jednej stronie, niskie ciśnienie i tchawicę przesuniętą na drugą stronę. Jakie jest prawdopodobne rozpoznanie?

1. AZapalenie płuc
2. BObrzęk płuc
3. COdma prężna
4. DAstma

A patient with a central venous catheter develops fever and rigors shortly after the line is flushed, with no other obvious source. What should be suspected?

1. ANormal response to line use
2. BAn allergic reaction to the saline flush
3. CA pulmonary embolism
4. DA catheter-related bloodstream infection

How should a patient breathe in when using a dry powder inhaler?

1. AQuickly and deeply, after breathing out away from the device
2. BThrough the nose with the mouthpiece in the mouth
3. CSlowly and gently over about ten seconds
4. DSeveral times, breathing out into the device between breaths

A patient with heart failure wakes extremely breathless, coughing pink frothy sputum. BP is 168/96 mmHg and SpO₂ 86%. Help has been called. What is the best initial nursing action?

1. ALie the patient flat with the legs raised on pillows
2. BGive a large IV fluid bolus to support the circulation
3. CSit the patient upright with the legs down and give oxygen
4. DEncourage the patient to walk to ease the breathing

Podczas leczenia DKA glikemia spada poniżej około 14 mmol/L (około 250 mg/dL), ale ketony nadal są podwyższone. Co zwykle się dzieje?

1. AWszystkie płyny dożylne zostają zatrzymane, aby uniknąć przeciążenia płynami
2. BDo płynów dodaje się glukozę; insulina jest kontynuowana
3. CPacjent zjada posiłek, a leczenie dożylne się kończy
4. DWlew insuliny zostaje natychmiast zatrzymany

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

Przez jak długo często obowiązują szczególne środki ostrożności przy płynach ustrojowych po wielu lekach chemioterapeutycznych?

1. AZwykle przez około 48 godzin
2. BNigdy nie są potrzebne
3. CTylko podczas wlewu
4. DPrzez cały rok

Two days after surgery, a patient on regular ibuprofen has a low urine output and a rising creatinine, and intake has been poor. What should the nurse do?

1. AChange to a higher-strength NSAID tablet
2. BWithhold the next dose and report to the prescriber
3. CIncrease the dose to treat the pain better and encourage fluids
4. DGive the next dose with extra food