Приоритизация и делегирование в стиле NCLEX: шпаргалка-пакет

A patient is admitted with diabetic ketoacidosis. Which prescribed treatment is usually started first?

1. AA high-carbohydrate meal
2. BIV isotonic fluid such as 0,9% sodium chloride
3. CSubcutaneous long-acting insulin only, given once
4. DOral potassium tablets

At 08:00 a nurse has four tasks. Which order is best?

1. AUpdate care plans, give insulin with breakfast, give routine medications, check the patient with a falling SpO₂
2. BGive routine medications, check the patient with a falling SpO₂, update care plans, give insulin with breakfast
3. CGive insulin with breakfast, update care plans, check the patient with a falling SpO₂, give routine medications
4. DCheck the patient with a falling SpO₂, give insulin with breakfast, give routine medications, update care plans

Before a blood transfusion is started, which check is required?

1. AThe patient’s identity is checked against the blood product and its paperwork at the bedside
2. BOne nurse checks the blood product against the order at the nurses’ station
3. CThe nurse checks only that the bag number matches the order
4. DThe patient signs the blood bag label to confirm their name before it is hung

Ten minutes into a red blood cell transfusion, the patient reports chills and low back pain and has a new fever. What should the nurse do first?

1. ASlow the transfusion and recheck vital signs in 15 minutes
2. BCall the blood bank and let the transfusion continue
3. CStop the transfusion
4. DGive an antipyretic and continue the transfusion

A patient with type 1 diabetes has the flu, is eating little and has a glucose of 290 mg/dL (16,1 mmol/L). Which advice is correct?

1. AKeep taking insulin and check blood or urine ketones
2. BWait 3 days before checking the glucose again
3. CDrink only water and avoid all carbohydrate foods
4. DStop all insulin until you are eating normally again

A patient on warfarin with an INR of 3,6 fell and hit their head an hour ago. They now report a worsening headache and drowsiness. What is the priority?

1. AReport urgently for imaging and possible reversal
2. BEncourage rest in a dark room to settle the pain
3. CGive acetaminophen (paracetamol) and recheck the INR tomorrow
4. DHold warfarin for one dose and observe at home

У пациента с диабетом 1 типа рвота, и он мало ест. Какой совет на «дни болезни» правилен?

1. AПрекратить инсулин, пока не восстановится нормальное питание, чтобы избежать гипогликемии
2. BНе прекращать инсулин; чаще проверять глюкозу и кетоны
3. CВдвое сократить приём жидкости, чтобы предотвратить рвоту
4. DПроверять глюкозу только один раз в день

A patient admitted after a fall takes many regular medicines. Which safety step on admission helps prevent medication errors?

1. AStopping all regular medicines until the day the patient is discharged
2. BPrescribing only the medicines that the patient can remember taking
3. CMedicines reconciliation against reliable sources, such as primary care records
4. DDoubling the doses to make up for any missed while at home

Which ECG change is classically linked with hyperkalaemia?

1. ATall, peaked T waves
2. BDelta waves before the QRS
3. CA sawtooth baseline
4. DProminent U waves

A patient with a confirmed pulmonary embolism has BP 78/50 mmHg despite fluids, and the right ventricle is dilated on echocardiography. Which treatment is most likely?

1. AAn inhaled bronchodilator
2. BSystemic thrombolysis
3. CCompression stockings and bed rest
4. DOral apixaban only, started next week

A patient's potassium stays low despite replacement. Which other level should be checked?

1. AAmylase
2. BBilirubin
3. CMagnesium
4. DFerritin

Which task for a patient with a urinary catheter can the nurse delegate to a healthcare assistant (nursing assistant)?

1. ADeciding whether the catheter can be removed
2. BAssessing a patient whose irrigation is not draining
3. CTeaching self-catheterisation for the first time
4. DEmptying the drainage bag and recording the volume

A patient on warfarin is booked for elective surgery with a high bleeding risk. What is usual practice?

1. ATake the usual dose on the morning of surgery
2. BStop it about 5 days before and check the INR
3. CSwap to aspirin on the morning of surgery
4. DDouble the dose for a week so the blood is ready for surgery

В хирургическом отделении четыре пациента. Какого пациента медсестра должна осмотреть первым?

1. AНейтропения: час назад температура была нормальной, чувствует себя хорошо
2. BЧерез четыре часа после операции на кишечнике: пульс 118/мин, АД 90/55 mmHg
3. C3-й день после операции: просит слабительное от запора
4. DСтабильная илеостома: просит помощи со сменой мешка