NCLEX Tarzı Önceliklendirme ve Görev Devri: hızlı tekrar paketi

Gündüz salonunda yemek yiyen yetişkin bir hasta aniden boğazını tutuyor ve konuşamıyor, soluyamıyor veya öksüremiyor. Hemşire önce ne yapmalıdır?

1. AAğızda kör parmak taraması yapmak
2. BHastanın öksürerek çıkarıp çıkaramayacağını beklemek
3. CYardım çağırmak ve sırta vurular ile abdominal itmeler uygulamak
4. DYiyeceği aşağı itmesi için hastaya bir bardak su vermek

A patient with a severe asthma attack had a PaCO₂ of 32 mmHg (4,3 kPa) on arrival. An hour later it is 46 mmHg (6,1 kPa), and the patient seems tired. What does this suggest?

1. ARespiratory muscle fatigue with possible impending respiratory failure
2. BThe patient is hyperventilating even more than before and needs calming
3. CThe asthma is improving, because the PaCO₂ is now near normal
4. DA laboratory error that should be ignored

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

1. ALying completely flat
2. BTrendelenburg position
3. CHead of the bed raised about 10 degrees
4. DHead of the bed raised 30 to 45 degrees

A patient takes medicines prescribed by several providers. Which advice best reduces the risk of medication errors at home?

1. AKeep each provider’s medicines in separate bags
2. BStop taking any medicine that seems to repeat another one, without asking anyone
3. CKeep one up-to-date list of all medicines and use one pharmacy where possible
4. DOnly tell each provider about the drugs they prescribed

Atriyal fibrilasyon nedeniyle varfarin kullanan bir hastanın INR'si 5,2'dir ve kanaması yoktur. Hemşirenin en iyi eylemi nedir?

1. AVarfarin dozunu tutmak ve reçeteyi yazan kişiyi bilgilendirmek
2. BOlağan dozu vermek ve bir ay sonra yeniden kontrol etmek
3. CÇift doz vermek
4. DHastaya bugünden itibaren yeşil sebze yemeyi bırakmasını önermek

A patient on IV gentamicin has a trough level above the target, and the creatinine has risen since yesterday. The next dose is due. What is the best action?

1. AGive the dose with extra oral fluids to protect the kidneys
2. BGive half of the dose and document the reason for it
3. CGive the dose now and recheck the levels next week
4. DHold the dose and report the results to the prescriber

When is a rapid-acting insulin such as insulin aspart usually given?

1. AOnce a week
2. BJust before or with a meal
3. COnly at bedtime
4. DTwo hours after finishing a meal

A patient with a central venous catheter needs the line removed. Which position reduces the risk of air embolism during removal of a neck or chest line?

1. ALying flat or slightly head-down, holding the breath or breathing out
2. BStanding up and walking
3. CSitting fully upright and taking a deep breath in as the line comes out
4. DLying on the right side with the legs raised

Which ECG change is classically linked with hyperkalaemia?

1. ADelta waves before the QRS
2. BA sawtooth baseline
3. CTall, peaked T waves
4. DProminent U waves

A patient with both COPD and heart disease is more breathless, with bilateral basal crackles, raised JVP, ankle swelling and a markedly raised NT-proBNP. Which problem is most likely driving this episode?

1. ADecompensated heart failure
2. BAn asthma attack
3. CA primary spontaneous pneumothorax
4. DHyperventilation from anxiety

Which signs suggest rejection of a kidney transplant?

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

A patient had rapid-acting insulin before lunch, then vomited the meal 15 minutes later. What should the nurse do?

1. AMonitor glucose closely and tell the prescriber about the hypo risk
2. BGive the evening long-acting insulin early to balance it
3. CIgnore it, because vomiting raises blood glucose
4. DGive another insulin dose because the meal was lost

Why should metoclopramide not be used for nausea in mechanical bowel obstruction?

1. AIt always causes severe diarrhoea
2. BIt increases gut movement against the blockage
3. CIt makes the bowel stop moving completely
4. DIt blocks the effect of all opioids

During burn resuscitation, a 70 kg adult's urine output has been 120 mL/h for 3 hours, and the face and limbs are very oedematous. What should the nurse do?

1. ADiscuss reducing the fluid rate with the team
2. BGive a diuretic without discussing it
3. CIncrease the fluid rate to keep the output high
4. DStop all IV fluids completely and remove the catheter