Приоритизация и делегирование в стиле NCLEX: шпаргалка-пакет

A patient taking clozapine reports a sore throat and fever. What is the priority action?

1. AHold the dose and report so the white cell count can be checked
2. BOffer throat lozenges and continue the usual dose
3. CAdvise the patient to gargle with warm salt water and rest in bed
4. DIncrease the dose because the symptoms suggest a relapse

A patient arrives one hour after the start of stroke symptoms. Which step must happen before a thrombolytic drug can be given?

1. AA full lipid profile to check cholesterol
2. BA brain scan to rule out bleeding
3. CAn echocardiogram to look for clots
4. DA swallow test with a cup of water

How should a nurse handle soiled bed linen?

1. AHold it away from the uniform and place it straight into a linen bag
2. BCarry it bundled against the body to the soiled utility room down the hall
3. CShake it out first to check for lost items
4. DPut it on the floor until the bed is made

A patient on long-term high-dose corticosteroids asks for the nasal spray influenza vaccine. What should the nurse explain?

1. AEither type is fine, as long as it is given in the morning
2. BThe nasal spray is a live vaccine, so the injected inactivated vaccine is used instead
3. CPeople on steroids should never have any influenza vaccine
4. DThe nasal spray is the best choice for people on steroids, because it is not injected

A nurse completed the hepatitis B vaccine series. Which result shows protective immunity?

1. AA positive HBsAg test
2. BA raised ALT level
3. CAnti-HBs of 10 mIU/mL or more
4. DA positive IgM anti-HBc

A young woman with frequent self-induced vomiting has swollen salivary glands. Which laboratory pattern is most likely?

1. AHigh potassium, low bicarbonate and low amylase
2. BHigh calcium, high phosphate and high glucose
3. CLow sodium, low bicarbonate and high lipase
4. DLow potassium, high bicarbonate and high amylase

In UK guidance, neutropenic sepsis is commonly defined by a temperature above 38 °C or signs of sepsis with a neutrophil count at or below:

1. A150 × 10⁹/L
2. B5 × 10⁹/L
3. C0,5 × 10⁹/L
4. D15 × 10⁹/L

An older patient found on the floor after lying there for many hours has dark brown urine and a very high creatine kinase. What is the main risk?

1. AA urinary tract infection from lying in urine
2. BHypoglycaemia
3. CA stroke
4. DAcute kidney injury from rhabdomyolysis

How does varenicline help people stop smoking?

1. AIt replaces nicotine through the skin, like a nicotine patch
2. BIt partly stimulates and partly blocks nicotine receptors
3. CIt makes cigarettes taste of metal so smoking feels unpleasant
4. DIt speeds the clearance of nicotine by the liver

Thirty minutes after extubation, a patient develops a high-pitched noise on breathing in and is anxious. SpO₂ is falling. What should the nurse do?

1. AEncourage the patient to sleep it off and recheck them in an hour
2. BLay the patient flat and reassure them
3. CGive a large drink of cold water to soothe the throat and settle it
4. DSit the patient up, give oxygen and call for urgent airway help

A patient on insulin asks about drinking alcohol. Which advice is correct?

1. AAlcohol raises glucose, so extra insulin should be taken first
2. BAlcohol can cause hypos, even the next day, so eat carbs with it
3. CAlcohol has no effect on blood glucose in people with diabetes
4. DAlcohol should replace a meal on the days it is drunk

A patient with an acute stroke has a glucose of 15 mmol/L (270 mg/dL). They do not have known diabetes. What is appropriate?

1. AGive glucose gel to stabilise the level
2. BStop all IV fluids to lower the glucose
3. CIgnore it, because stress always raises glucose
4. DReport it and monitor glucose, as it can worsen outcome

Which statement correctly describes physical dependence on opioids?

1. AThe drug no longer has any side effects
2. BThe patient always craves the drug and misuses it despite harm
3. CThe patient is allergic to opioids
4. DWithdrawal occurs if the drug is stopped suddenly

A nurse teaches a patient with a new ileostomy. Which statement shows a need for further teaching?

1. A"I'll chew my food well to avoid blockages."
2. B"I'll watch for dizziness and dark urine."
3. C"I'll report if my output becomes very watery and high."
4. D"I'll drink less so my bag fills more slowly."