Приоритизация и делегирование в стиле NCLEX: шпаргалка-пакет

Before giving a scheduled dose of metoprolol, which assessment is most important?

1. AApical pulse and blood pressure
2. BTemperature and the latest pain score
3. CBowel sounds and urine color
4. DBlood glucose and weight

Several patients on a unit develop diarrhea within two days. What should the nurse do first?

1. AGive all patients antidiarrheal drugs without assessment
2. BPlace affected patients on contact precautions and inform infection control
3. CWait to see if more patients become unwell
4. DMove the affected patients into shared rooms with other patients to free up beds

Sputum specimens are ordered to look for acid-fast bacilli (TB). How are they usually collected?

1. AThree deep-cough specimens collected 8 to 24 hours apart, at least one early in the morning
2. BOne specimen of sputum collected straight after the evening meal, when coughing is easiest
3. CThree specimens collected after an antiseptic mouthwash
4. DOne saliva sample collected at any convenient time of day

A nurse teaches new parents how to cope with an infant’s crying. Which statement shows a need for further teaching?

1. A“If he won’t stop crying, a quick shake will get his attention.”
2. B“If I get frustrated, I will put him safely in the crib and take a short break.”
3. C“I can call a friend or family member to help when I am tired.”
4. D“I will check whether he is hungry, wet or too warm.”

Which blood collection practice helps prevent hemolysis of the sample?

1. ALeaving the tourniquet on for at least 3 minutes
2. BUsing the smallest needle available for every patient
3. CGently inverting the tubes instead of shaking them
4. DForcing blood quickly through a needle into the tube

A patient has fatigue, weight gain and constipation. Results: TSH 24 mIU/L, free T₄ low, total cholesterol 285 mg/dL (7,4 mmol/L), sodium 131 mEq/L. What is the best interpretation?

1. AHyperthyroidism, with suppressed thyroid hormone production
2. BSecondary hypothyroidism from failure of the pituitary gland
3. CPrimary hypothyroidism, which can raise lipids and lower sodium
4. DFamilial hypercholesterolemia, unrelated to the thyroid results

У пациента с нейтропенией после химиотерапии температура 38,3 °C. Что приоритетно?

1. AПодождать 24 часа, не снизится ли температура
2. BДать только парацетамол и снова перепроверить температуру завтра
3. CРасценивать как нейтропенический сепсис и срочно ввести внутривенные антибиотики
4. DПредложить пациенту прогуляться

Анализ крови пациента показывает калий 6,8 mmol/L, на ЭКГ — заострённые зубцы T. Какое лечение быстрее всего защищает сердце?

1. AПероральные препараты калия
2. BФуросемид в таблетках на следующий день
3. CКальция глюконат внутривенно
4. DТолько диета с низким содержанием калия

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

1. AAsthma
2. BStable angina
3. CPhaeochromocytoma
4. DAortic stenosis

A patient being treated for pulmonary TB repeatedly misses doses and stops when they feel better. Which strategy is most effective?

1. ADoubling the dose on the days the patient remembers to take it
2. BSwitching to a single drug to make it easier
3. CDirectly observed therapy with support for barriers to adherence
4. DStopping treatment, as it is clearly not working for this patient

After a lumbar discectomy, which finding should the nurse report promptly?

1. AStiffness when getting out of bed
2. BNew weakness or numbness in the legs
3. CMild pain at the wound site
4. DA dry, intact wound dressing

A kidney transplant recipient has had vomiting and diarrhoea for two days. Why should the transplant team be contacted?

1. AVomiting proves that rejection has already happened
2. BThe patient may not be absorbing their immunosuppressants
3. CThe tablets will make the vomiting stop
4. DThe kidney will start to produce far too much urine

Which risk is particularly linked with tramadol?

1. ASevere stomach ulcers in all patients
2. BHigh blood pressure that needs emergency treatment in most patients
3. CSerotonin syndrome with some antidepressants, and seizures
4. DRapid liver failure at normal doses

A patient on modified-release morphine for cancer pain has needed four breakthrough doses every day for several days. What should the nurse do?

1. ATell the patient to put up with the pain between doses
2. BGive all breakthrough doses at the same time
3. CStop the breakthrough doses to reduce opioid use
4. DReport it, as the regular background dose may need review