Priorytetyzacja i delegowanie w stylu NCLEX: zestaw na powtórkę

Pielęgniarka deleguje pomiar glikemii przeszkolonemu asystentowi, ale nigdy nie pyta o wynik. Którego „właściwego” elementu delegowania brakuje?

1. AWłaściwego nadzoru i oceny
2. BWłaściwych okoliczności
3. CWłaściwego zadania dla danego miejsca
4. DWłaściwej osoby do zadania

Pielęgniarka uważa, że zlecona dawka jest niebezpieczna. Zlecający mówi, żeby ją mimo to podać. Co powinna zrobić pielęgniarka?

1. APodać połowę dawki jako kompromis i udokumentować powód
2. BPodać dawkę, ponieważ odpowiedzialność ponosi teraz zlecający
3. CWstrzymać dawkę i zgłosić sprawę zgodnie ze ścieżką służbową
4. DPo cichu pominąć dawkę i nic nie mówić, aby uniknąć konfliktu

A child has swallowed a button battery. Why is this urgent?

1. AIt is only harmful if several batteries are swallowed
2. BThe only risk is poisoning from heavy metals years later
3. CIt can burn through the lining of the esophagus within hours
4. DIt always passes through the gut without harm

A toddler has bruises of different ages and a burn, and the parent’s explanation does not fit the injuries. What should the nurse do?

1. AWait until there is clear proof of abuse before reporting anything at all
2. BDocument only and say nothing to anyone
3. CConfront the parent and ask them to admit to abuse
4. DReport the concern following child-protection (safeguarding) procedures

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

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

A young man has a swollen knee after minor trauma. His aPTT is prolonged, but his PT/INR and platelet count are normal. Which condition fits best?

1. AHemophilia A (factor VIII deficiency)
2. BDisseminated intravascular coagulation
3. CImmune thrombocytopenia (ITP)
4. DVitamin K deficiency from poor diet

Pacjent z cukrzycą typu 2 jest w ciężkim stanie, znacznie odwodniony i ma glikemię 40 mmol/L bez istotnej ketonemii. Jakie jest najbardziej prawdopodobne rozpoznanie?

1. AMoczówka prosta
2. BHipoglikemia
3. CCukrzycowa kwasica ketonowa z odwodnieniem
4. DHiperglikemiczny stan hipermolalny

A patient with a small leg wound has severe pain out of proportion to the skin changes, rapidly spreading redness and signs of sepsis. What should be suspected?

1. ANecrotising fasciitis
2. BAn allergic reaction to the dressing
3. CA superficial bruise
4. DSimple cellulitis that will settle with oral antibiotics

Analysis of a pleural effusion shows it is an exudate (high protein and LDH compared with blood). Which cause is most likely?

1. APneumonia or cancer affecting the pleura
2. BLiver cirrhosis with a low albumin
3. CNephrotic syndrome with protein lost in urine
4. DHeart failure with raised venous pressure

During drainage of a large pleural effusion, a patient starts coughing and feels tight in the chest. What should the nurse do?

1. AAsk the patient to cough harder to help the flow
2. BSpeed up the drainage to finish quickly
3. CLie the patient flat until the drainage is complete
4. DStop or clamp the drainage and inform the doctor

Which group of drugs is a well-known cause of SIADH and hyponatraemia, especially in older people?

1. APenicillin antibiotics
2. BSSRI antidepressants
3. CProton pump inhibitors
4. DBulk-forming laxatives

A patient with hypopituitarism needs both hydrocortisone and levothyroxine. Which is usually started first?

1. ANeither, until symptoms appear
2. BLevothyroxine
3. CBoth on the same day, in any order
4. DHydrocortisone

Which statement about corticosteroids in inflammatory bowel disease is correct?

1. AThey cure the disease after one course
2. BThey are the best long-term maintenance treatment
3. CThey are given only as a one-off injection
4. DThey are used to induce remission, not for maintenance

Which preoperative task can a registered nurse usually delegate to a healthcare assistant (nursing assistant)?

1. ARecording baseline vital signs
2. BAssessing the patient's understanding of the surgery
3. CDeciding whether abnormal results need reporting
4. DTeaching the patient how to use a PCA pump