NCLEX 风格的优先排序与委派：速成包

A patient with schizophrenia says voices are telling him to hurt his roommate. What is the priority?

1. AAsk the roommate to stay in the room with him and help calm him down
2. BTell him the voices are not real and leave him alone
3. CKeep everyone safe and tell the team, as the risk of harm is high
4. DIgnore the comment, because voices are part of his illness

A patient is deteriorating quickly. The nurse has called the provider twice, but the provider has not come. What is the best action?

1. AAsk the patient’s family to call the provider
2. BActivate the rapid response team
3. CWait another hour and call the provider again
4. DDocument the concern and continue routine care

Which nursing care reduces the risk of ventilator-associated pneumonia?

1. ALying the patient flat for most of the day
2. BRegular oral care to reduce bacteria in the mouth
3. CLeaving secretions in the mouth to protect the airway
4. DChanging the ventilator circuit every few hours

A small-bore feeding tube has just been inserted blindly at the bedside. Which method is the most reliable way to confirm its position before the first feeding?

1. ABy an x-ray reviewed by a competent clinician
2. BBy listening over the stomach while injecting air
3. CBy checking that the patient can still talk
4. DBy putting the end in water to look for bubbles

An older adult takes lisinopril and furosemide and recently started daily ibuprofen for knee pain. The creatinine has risen from 1.0 to 1.8 mg/dL (88 to 159 µmol/L). What is the most likely cause?

1. ANormal aging of the kidneys over a period of a few weeks
2. BThe NSAID reduces kidney blood flow on top of the other two drugs
3. CMore activity has increased the patient's muscle mass quickly
4. DA laboratory error, since ibuprofen has no effect on the kidney

一名服用噻嗪类利尿剂的患者钠 129 mEq/L，钾 3.2 mEq/L，感觉乏力。哪种解释最合适？

1. A患者有原发性醛固酮增多症，钠高
2. B患者只是静脉输液导致水过多
3. C这些结果是肾衰竭的典型表现
4. D利尿剂导致钠和钾丢失

In suspected sepsis, what should ideally be collected before the first dose of antibiotics, as long as it does not delay treatment?

1. AA stool sample for occult blood
2. BA fasting cholesterol level
3. CA 24-hour urine collection
4. DBlood cultures

A patient's hypoglycaemia was caused by a sulfonylurea such as gliclazide or glipizide. Why might they need monitoring for longer than usual?

1. AThe drug causes rebound hyperglycaemia later the same day
2. BSulfonylureas act for a long time, so hypoglycaemia can recur
3. CThe drug makes glucose tablets and drinks ineffective
4. DSulfonylureas only work at night

Why should a long-acting beta-2 agonist (LABA) never be used alone in asthma?

1. AIt always causes immediate severe bronchospasm when used on its own
2. BIt works only when it is taken together with a course of antibiotics
3. CIt cannot be inhaled without a nebuliser
4. DWithout an inhaled steroid, it is linked with severe and fatal attacks

A patient receiving weeks of IV antibiotics through a PICC line in the left arm develops swelling and aching of that arm and neck veins that look fuller on the left. What should the nurse suspect?

1. AA local skin allergy to the dressing
2. BLymphoedema from lying in bed
3. CA catheter-related deep vein thrombosis
4. DAn expected effect of the antibiotic

一名 C6 水平急性脊髓损伤患者，哪种表现提示神经源性休克？

1. A血压正常、脉搏快、高热
2. B低血压、脉搏缓慢、皮肤温暖干燥
3. C高血压、脉搏缓慢、剧烈头痛
4. D低血压、脉搏快、皮肤冰冷湿冷

一名卒中并右侧肢体无力的患者准备从床转移到椅子上。哪种方法最安全？

1. A让患者独自站起并走到椅子上
2. B拉着右肩和手腕把患者拉起来
3. C把椅子放在右侧，并拉着患侧手臂提起
4. D把椅子放在左侧，并向椅子方向转身

Why is pethidine (meperidine) generally avoided for regular pain relief?

1. AIt can only be given by mouth
2. BIt has no pain-relieving effect at all in adults
3. CIt always causes severe diarrhoea
4. DA metabolite can build up and cause seizures

一名两个月前放置了冠状动脉支架、服用阿司匹林和氯吡格雷的患者出现黑便，现在情况稳定。对抗血小板药物，最恰当的处理是什么？

1. A报告出血；由团队在心脏科的参与下决定，权衡出血与支架血栓
2. B永久停用两种药物，因为任何出血都意味着它们不再安全
3. C两种药物原样继续，并且不向团队提及出血
4. D将两种药物的剂量加倍，因为出血意味着支架有更大的血栓风险