Приоритизация и делегирование в стиле NCLEX: шпаргалка-пакет

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

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

A nurse must care for a patient with a radioactive implant. Which approach best limits the nurse’s exposure?

1. ALimit time in the room, keep as far away as possible and use shielding
2. BWear a surgical mask to block the radiation
3. CStand close to the patient to finish care faster
4. DSpend longer in the room each time but visit less often during the shift

Why is blood glucose control important around the time of surgery?

1. AHigh glucose impairs white cell function and raises the risk of surgical site infection
2. BHigh glucose makes anesthetic drugs work for much longer and delays waking up
3. CLow glucose is needed around surgery so that the wound edges close more quickly
4. DGlucose levels only affect patients who have type 1 diabetes

A patient’s WBC is 4,000/mm³, with 30% neutrophils and 5% bands. What is the absolute neutrophil count (ANC)?

1. A3,500/mm³
2. B140/mm³
3. C1,200/mm³
4. D1,400/mm³

У пациента на варфарине по поводу фибрилляции предсердий МНО 1,4. Что это означает?

1. AАнтикоагуляция ниже цели, поэтому тромбы и инсульт более вероятны
2. BДоза абсолютно правильная и не требует изменений
3. CПациенту больше не нужно принимать варфарин
4. DУ пациента высокий риск кровотечения, и ему сразу нужен витамин K

Общий кальций у пациента 7,9 mg/dL (2,0 mmol/L), альбумин 2,4 g/dL (24 g/L), симптомов нет. Какой тест лучше всего покажет, есть ли истинная гипокальциемия?

1. AОтносительная плотность мочи
2. BHbA1c
3. CИонизированный кальций
4. DНатрий сыворотки

Which advice is important for a patient on long-term oral corticosteroids?

1. ATake them only when symptoms flare
2. BDo not stop them suddenly
3. CDouble the dose if a dose is missed
4. DTake them on an empty stomach at night

Which nursing measure helps reduce raised intracranial pressure?

1. ATilting the patient head-down
2. BLying the patient flat with the neck flexed forward on two pillows
3. CRaising the head of the bed to about 30° with the head kept midline
4. DFrequent suctioning and encouraging strong coughing

How is orthostatic (postural) hypotension usually assessed?

1. ABP once sitting, then once lying down straight after a large meal
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 in both arms at the same moment while sitting

A ventilated patient suddenly desaturates to 82%. The cause is not obvious and the ventilator alarms are sounding. What should the nurse do first?

1. ASilence the alarm and wait for the result of the next routine blood gas
2. BChange the ventilator settings to a higher rate
3. CDisconnect and hand-ventilate with 100% oxygen while calling for help
4. DIncrease the sedation and watch the monitor for the next half hour

Which signs suggest rejection of a kidney transplant?

1. AMore urine, a falling creatinine and weight loss
2. BA rash on the face after sun exposure
3. CLess urine, a rising creatinine and a tender graft
4. DA cough, wheeze and a runny nose with sneezing

A man who takes tamsulosin for BPH is listed for cataract surgery. Which statement is correct?

1. AIt should be swapped for oxybutynin the night before to protect the eye
2. BThe dose should be doubled before surgery to prevent urinary retention
3. CThe eye surgeon must be told, as it can cause floppy iris during surgery
4. DTamsulosin has no effects outside the urinary tract, so nothing changes

Which intervention most reduces pressure ulcer risk in an immobile patient?

1. ARegular repositioning and a pressure-redistributing mattress
2. BMassaging red areas firmly at each turn to bring back the circulation
3. CKeeping the head of the bed raised at 90° all day
4. DUsing a doughnut-shaped ring cushion

A patient with recurrent diverticulitis reports passing air and faecal matter in the urine. What is the most likely cause?

1. ABowel preparation that was taken too quickly
2. BA fistula between the colon and the bladder
3. CA simple lower urinary tract infection
4. DA kidney stone blocking the ureter