Приоритизация и делегирование в стиле NCLEX: шпаргалка-пакет

An arterial blood gas shows pH 7,28, PaCO₂ 40 mmHg (5,3 kPa) and HCO₃⁻ 16 mEq/L (mmol/L). How should the nurse interpret it?

1. ARespiratory acidosis
2. BRespiratory alkalosis
3. CMetabolic acidosis
4. DMetabolic alkalosis

A patient with anorexia nervosa is admitted. Which finding is the priority?

1. ARefuses to eat in front of other people
2. BHas fine, downy hair on her arms
3. CHeart rate 38/min and potassium 2,8 mEq/L
4. DSays she feels fat although she is very thin

A patient is on a ventilator. Which bed position helps to prevent ventilator-associated pneumonia?

1. AHead of the bed raised about 10 degrees
2. BHead of the bed raised 30 to 45 degrees
3. CLying completely flat
4. DTrendelenburg position

Which patient with a suspected infection meets at least two SIRS criteria?

1. ATemperature 38,6 °C and heart rate 112/min
2. BRespiratory rate 16/min and WBC 8,000/mm³
3. CTemperature 36,8 °C and respiratory rate 18/min
4. DTemperature 37,2 °C and heart rate 80/min

Пациент на варфарине начал ежедневно есть большие порции капусты кале и шпината. МНО снизилось. Какой совет наиболее уместен?

1. AПоддерживать потребление продуктов, богатых витамином K, стабильным изо дня в день
2. BПрекратить варфарин, пока питание не нормализуется
3. CУдвоить дозу варфарина, не сообщив врачу
4. DБольше никогда не есть зелёные овощи

A child with sickle cell disease and a recent viral illness is pale and tired. The hemoglobin has fallen sharply, and the reticulocyte count is very low. What is the most likely problem?

1. AA vaso-occlusive pain crisis in the bones
2. BIron deficiency from a poor diet over months
3. CAn aplastic crisis, often caused by parvovirus B19
4. DA normal finding in sickle cell disease

У пациента с диабетом без сознания глюкоза крови 2,1 mmol/L, внутривенного доступа нет. Что можно ввести?

1. AИнсулин подкожно
2. BГлюкагон внутримышечно
3. CТаблетки глюкозы через рот
4. DФруктовый сок через рот

Why must a unit of red cells be transfused within the set time limit (commonly four hours) after it leaves controlled cold storage?

1. AThe red cells break down and turn into plasma
2. BThe blood group of the cells changes after a few hours
3. CThe bag stops dripping after four hours
4. DBacteria can grow in the blood at room temperature

How is orthostatic (postural) hypotension usually assessed?

1. ABP in both arms at the same moment while sitting
2. BBP only standing, after a brisk walk along the corridor
3. CBP lying after rest, then again after 1 and 3 minutes standing
4. DBP once sitting, then once lying down straight after a large meal

An adult inhales a peanut while laughing and now has a persistent cough and wheeze on one side. Where is the peanut most likely to have lodged?

1. AThe nasal cavity
2. BThe oesophagus
3. CThe right main bronchus
4. DThe left main bronchus

Which group of problems is typical of primary hyperparathyroidism?

1. AMuscle cramps, tingling lips and seizures
2. BHeat intolerance, tremor, weight loss and diarrhoea
3. CHair loss, weight gain and feeling cold
4. DKidney stones, bone pain, abdominal pain and low mood

A patient with acromegaly snores loudly, stops breathing at times in sleep and is sleepy during the day. What is most likely?

1. ANarcolepsy
2. BAn anxiety disorder
3. CObstructive sleep apnoea
4. DNormal snoring

How is an uncomplicated sigmoid volvulus often first treated?

1. AEating a large high-fibre meal
2. BA barium meal given by mouth to untwist the bowel slowly
3. CHigh-dose laxatives taken by mouth
4. DDecompression with a flexible sigmoidoscope and flatus tube

A nurse teaches a patient after a colonoscopy with polyp removal. Which statement shows a need for further teaching?

1. A"I should report a fever or a swollen, painful abdomen."
2. B"Severe abdominal pain is normal for a week afterwards."
3. C"Some wind and bloating today is expected."
4. D"I'll report heavy bleeding from my bottom."