Приоритизация и делегирование в стиле NCLEX: шпаргалка-пакет

A patient on a continuous IV heparin infusion has new black, tarry stools and an aPTT well above the target range. What should the nurse do first?

1. ACheck the pump rate and leave the infusion running
2. BOffer an iron-rich meal to replace the lost blood
3. CGive a dose of vitamin K by mouth
4. DStop the heparin infusion and inform the provider

A severely malnourished patient started nutrition two days ago and now has weakness and confusion. Which laboratory result should the nurse check first?

1. AThyroid hormone
2. BSerum cholesterol
3. CSerum amylase
4. DSerum phosphate

A patient with a fever and a cough arrives in a crowded clinic waiting room. What should the nurse do?

1. AAsk the patient to wait outside in the car park
2. BDo nothing until the patient is seen by the provider
3. CGive the patient a mask and seat them apart from others
4. DGive everyone else in the waiting room a mask instead

Which position is especially dangerous for a patient in physical restraints?

1. ASitting upright in bed
2. BLying on the back with the head raised
3. CLying on the side
4. DLying face down (prone)

A patient has a calcium of 11,8 mg/dL (2,95 mmol/L) from bone metastases. Which nursing measure is appropriate?

1. AEncourage bed rest and limit oral fluids
2. BEncourage fluids and mobility as tolerated
3. CGive calcium carbonate antacids for nausea
4. DOffer extra milk and cheese at each meal

A patient's low calcium does not improve despite several days of calcium replacement. Which other electrolyte should be checked and corrected?

1. AChloride
2. BMagnesium
3. CSodium
4. DBicarbonate

Why are patients with atrial fibrillation often given anticoagulants?

1. ATo slow the heart rate directly and prevent palpitations
2. BTo convert the rhythm back to normal
3. CTo reduce the risk of stroke from clots in the atria
4. DTo lower the blood pressure

A patient with full mental capacity decides against a treatment that the team thinks is best. What does the Mental Capacity Act 2005 (England and Wales) say?

1. AA person is not treated as lacking capacity just because they make an unwise decision
2. BThe family may make the decision instead if they disagree with the patient's choice
3. CThe team may override any decision that it disagrees with if it is serious
4. DThe patient must be assessed by a psychiatrist before refusing

A patient has episodes of severe headache, sweating and palpitations with very high blood pressure. Which rare cause should be considered?

1. AAsthma
2. BAortic stenosis
3. CStable angina
4. DPhaeochromocytoma

У пациента, принимающего дабигатран, тяжёлое желудочно-кишечное кровотечение. Какой специфический антидот можно использовать?

1. AФитоменадион (витамин K)
2. BТолько транексамовую кислоту
3. CИдаруцизумаб
4. DПротамина сульфат

Why might a patient taking a beta-blocker not notice a hypoglycaemic episode?

1. ABeta-blockers can mask the tremor and racing heart of a hypo
2. BBeta-blockers make the patient sleep through every hypo
3. CBeta-blockers raise blood glucose, so hypos cannot happen
4. DBeta-blockers block the effect of all diabetes medicines

У пациента с травмой спинного мозга на уровне T4 пульсирующая головная боль, АД 210/110 mmHg, покрасневшая потная кожа выше уровня травмы и пульс 50/мин. После того как пациента посадили, каков следующий приоритет?

1. AВвести быстрый болюс внутривенной жидкости для поддержки кровообращения
2. BСнова уложить пациента плашмя и поднять ноги на подушки
3. CДать седативное средство и перепроверить давление через час
4. DНайти и устранить триггер, начиная с мочевого пузыря

Какое утверждение лучше всего описывает толерантность к опиоидам?

1. AСо временем нужна более высокая доза для того же эффекта
2. BУ пациента навязчивое стремление к большему количеству препарата
3. CУ пациента развилась аллергия на препарат
4. DПрепарат больше не вызывает запор

Which new prescription for a patient with cirrhosis should the nurse question?

1. ASpironolactone for ascites
2. BRegular ibuprofen for back pain
3. CLactulose to keep the bowels open
4. DThiamine supplements