Пріоритезація та делегування у стилі NCLEX: шпаргалка-підсумок

Якого пацієнта медсестра має оглянути першим?

1. AПацієнта з діабетом 2 типу, який питає про дієту
2. BПацієнта з давнім ревматоїдним артритом і звичною ранковою скутістю суглобів
3. CПацієнта з новою нечіткою мовою та опущенням обличчя, що почалися 30 хвилин тому
4. DПацієнта з хронічною хворобою нирок, якому завтра діаліз

A patient with raised intracranial pressure is being nursed on the ward. Which position is best?

1. AFlat on the back with the head turned well over to one side
2. BHead of the bed at about 30 degrees with the neck straight
3. CHead down with the legs raised above the heart
4. DSitting forward with the chin on the chest

A nurse who never had BCG vaccine has a positive tuberculin skin test for the first time. The chest x-ray is clear and there are no symptoms. What does this most likely mean?

1. AImmunity to TB from a past exposure
2. BA failed test that must be repeated next year
3. CActive TB, which needs airborne isolation
4. DLatent TB infection, which is not contagious

A 2-year-old living in a house built many decades ago has anemia, irritability and poor appetite. Which cause should the nurse suspect?

1. ACarbon dioxide from a gas cooker
2. BLead poisoning from old paint dust or chips
3. CA food allergy to cow’s milk proteins
4. DIron overload from eating too much red meat

A patient has macrocytic anemia with numbness and tingling of the feet and poor balance. Which deficiency is most likely?

1. AVitamin B₁₂
2. BIron (low ferritin)
3. CVitamin C (ascorbic acid)
4. DFolate (folic acid)

A patient with chronic kidney disease stage 4 has a high phosphate, a low-normal calcium and a very high parathyroid hormone (PTH). What does this show?

1. ASecondary hyperparathyroidism from CKD
2. BHypoparathyroidism after neck surgery
3. CVitamin D toxicity from supplements
4. DPrimary hyperparathyroidism from a tumor

Which drug is first-line in an acute asthma attack?

1. AA nebulised or inhaled short-acting beta₂-agonist (salbutamol/albuterol)
2. BAn oral antihistamine such as cetirizine taken every few hours
3. CA long-acting inhaled corticosteroid, used alone at a higher dose
4. DAn oral beta-blocker

A severely hypothermic patient is in cardiac arrest. Why is resuscitation usually continued until they are rewarmed?

1. AAdrenaline works better in cold patients
2. BHypothermia always causes brain death quickly
3. CThe cold protects the brain, so recovery may be possible after long resuscitation
4. DCold patients cannot be defibrillated at all, so CPR is the only possible treatment

У пацієнта біль посередині грудей і STEMI на ЕКГ. Що це зазвичай потребує?

1. AЕкстреної реперфузії, переважно первинного ЧКВ
2. BПерорального бета-блокатора та виписки, якщо біль минув
3. CГоспіталізації та повторної ЕКГ наступного ранку
4. DРезультату тропоніну до ухвалення будь-якого рішення про лікування

The monitor shows a regular broad-complex tachycardia at 180/min. The patient is alert with BP 126/78 mmHg and no chest pain. What is the most appropriate plan?

1. ARecord a 12-lead ECG, call senior help and anticipate an antiarrhythmic
2. BReassure the patient, as this is a normal rhythm
3. CStart chest compressions straight away and give a dose of IV adrenaline
4. DDeliver an unsynchronised shock immediately, before any other assessment

A bladder scan straight after voiding shows 450 mL of urine still in the bladder. What does this show?

1. AThe kidneys are making too little urine
2. BThe bladder is not emptying properly
3. CThe patient has drunk too little fluid
4. DThe patient is passing urine normally

Пацієнт на ШВЛ має черепно-мозкову травму. Яку ціль PaCO₂ зазвичай ставлять, якщо немає неминучого вклинення?

1. AНизький PaCO₂ від тривалої гіпервентиляції
2. BБудь-який PaCO₂, бо він не впливає на ВЧТ
3. CВисокий PaCO₂, щоб розкрити мозкові судини
4. DНормальний PaCO₂ (нормокапнія)

How should pancreatic enzyme replacement capsules usually be taken?

1. AOnce a day at bedtime
2. BOnly on days with abdominal pain
3. CWith every meal and snack
4. DOne hour after meals, on an empty stomach

During preoperative assessment, a patient says their brother had a "very high fever" during an anaesthetic. What is the most important action?

1. AReassure the patient that fevers after anaesthesia are always harmless
2. BGive paracetamol before surgery to prevent fever
3. CInform the anaesthetist, as malignant hyperthermia may run in the family
4. DRecord it as a family allergy to paracetamol