Приоритизация и делегирование в стиле NCLEX: шпаргалка-пакет

A nurse teaches a patient about levothyroxine. Which statement shows a need for further teaching?

1. A“I will keep taking it even when I feel well.”
2. B“I will take it at breakfast with my calcium tablet.”
3. C“I will take it at the same time each morning.”
4. D“I will take it on an empty stomach with a glass of water.”

Four laboratory results come back at once. Which one should the nurse report first?

1. AGlucose 180 mg/dL after a meal in a patient with diabetes
2. BCreatinine 1,3 mg/dL in an older adult, unchanged from last week
3. CHemoglobin 6,5 g/dL (65 g/L) in a patient with a GI bleed
4. DPotassium 3,4 mEq/L in a patient on a diuretic

Which practice reduces back strain when a nurse moves a patient or heavy object?

1. AKeep the load close to the body and avoid twisting
2. BHold the load at arm’s length to keep it steady
3. CBend at the waist and keep both knees straight
4. DStand with the feet close together for balance

A hospital will introduce new infusion pumps and wants to find out how the process could fail before any harm occurs. Which method fits best?

1. ARoot cause analysis (RCA) of the new pumps
2. BAn incident report for each new pump
3. CA morbidity and mortality meeting
4. DFailure mode and effects analysis (FMEA)

A patient has a hot, swollen big toe. The serum uric acid is normal. Which statement is correct?

1. AGout is still possible, as urate can be normal in an attack
2. BGout is certain, as a normal urate proves the diagnosis
3. CGout is ruled out, as uric acid is always high in an attack
4. DGout can only be diagnosed with a CT scan of the foot

A patient using an insulin pump has a glucose of 300 mg/dL (16,7 mmol/L) that has not fallen 2 hours after a correction bolus through the pump. Blood ketones are 1,8 mmol/L. What is the most likely problem and action?

1. AInsulin overdose from the pump; suspend the pump and stop all insulin for a day
2. BRebound after a hypo; give fast-acting carbohydrate and recheck in 15 minutes
3. CNormal pump function; wait for the next mealtime bolus to lower the glucose
4. DInsulin delivery failure; inject a correction dose by pen and change the set

After a laparoscopic cholecystectomy, a patient has pain in the shoulder tip. What is the most likely cause?

1. AAn allergic reaction to the dressing
2. BA heart attack caused by the stress of surgery
3. CGas used during the operation irritating the diaphragm
4. DA broken collarbone from being moved onto the table

Пациент с трахеостомой внезапно не может дышать, трубка кажется закупоренной. Каково первое действие?

1. AСдуть манжету и оставить пациента
2. BЖдать врача, прежде чем что-либо делать
3. CДавать кислород только через рот
4. DИзвлечь внутреннюю канюлю и проверить, не закупорена ли она

How can a patient reduce wound pain when coughing after abdominal surgery?

1. AHold the breath for as long as possible
2. BHold a pillow firmly against the wound while coughing
3. CLie flat on the back with the legs straight
4. DAvoid coughing completely until all the stitches are removed

After an anaphylactic reaction to a bee sting that responded to adrenaline (epinephrine), a patient asks to go home immediately. Which advice is most appropriate?

1. AGo home and take antihistamines only if the throat swells
2. BStay in hospital for at least two weeks on daily intravenous antihistamines
3. CStay for observation, then go home with an adrenaline auto-injector and teaching
4. DGo home straight away, because anaphylaxis never recurs once adrenaline has worked

A patient has had a calcium oxalate kidney stone. Which advice best helps prevent another?

1. ADrink plenty of fluid so the urine stays pale
2. BTake extra vitamin C supplements
3. CDrink only a little to avoid diluting the urine
4. DCut all calcium out of the diet

The nurse has four renal patients. Which one needs to be seen first?

1. AA patient with CKD asking about their phosphate binder
2. BA patient with a potassium of 6,8 mmol/L who reports palpitations
3. CA patient with mild itching from uraemia who wants a cream
4. DA patient with a creatinine slightly above their usual level

Why are antimotility drugs such as loperamide avoided in C. difficile infection?

1. AThey may keep toxin in the bowel and risk toxic megacolon
2. BThey cause serious liver failure in most patients who take them
3. CThey kill the normal bowel bacteria
4. DThey make the stool sample test positive falsely

Пациента, длительно принимающего опиоид по поводу хронической боли, госпитализируют для операции. Какое утверждение верно?

1. AОбычный опиоид продолжают плюс дополнительное обезболивание из-за толерантности
2. BВсе опиоиды следует отменить при поступлении, чтобы предотвратить зависимость
3. CПосле завершения операции им следует давать только парацетамол
4. DИм нужны меньшие послеоперационные дозы опиоидов, чем пациентам, ранее не получавшим опиоиды