NCLEX 风格的优先排序与委派：速成包

A patient with heart failure gained 2 kg (about 4 lb) since yesterday and is more breathless when lying down. What should the nurse do first?

1. AEncourage extra fluids to correct the weight change
2. BRecord the weight on the chart and recheck it at the next weekly weigh-in
3. CAssess the lungs, oxygen saturation and swelling, then inform the provider
4. DLay the patient flat to help them breathe more easily

一名护士正在监督一名新的护理助理。护士何时应最仔细地检查助理的工作？

1. A当助理对该任务不熟悉或患者不太稳定时
2. B仅在助理为觉得困难的任务求助时
3. C从不，因为助理持有该角色的证书
4. D仅在班次结束、审阅记录时

哪种敷料废弃物应丢入医疗（生物危害）废物？

1. A擦手用的干净纸巾
2. B已过期但未开封的敷料
3. C被感染伤口渗液浸湿的敷料
4. D无菌敷料包的外层纸包装

A nurse discovers that an insulin infusion was programmed using the wrong drug concentration in the pump library. What should the nurse do first?

1. ADouble the rate to correct for the error
2. BLeave it running and check the glucose at the next routine time
3. CReprogram the pump and finish the shift before reporting
4. DStop the infusion and check the patient’s blood glucose

A test has very high sensitivity for a disease. What does a negative result mean?

1. AThe patient must have a different disease instead
2. BThe disease is certain, so treatment should begin
3. CThe disease is unlikely, so it helps rule it out
4. DThe result cannot be used, because sensitivity is high

The nurse teaches a patient with chronic kidney disease about a potassium-restricted diet. Which statement shows a need for further teaching?

1. A"Dried apricots and raisins will be a good snack for me now"
2. B"I'll limit bananas, oranges and potatoes in my meals"
3. C"I can leach potatoes by soaking them before cooking them"
4. D"I'll check food labels and ask my dietitian about portion sizes"

一名患者腹部僵硬如板，因活动会加重疼痛而一动不动地躺着。这提示什么？

1. A消化不良
2. B便秘
3. C尿路感染
4. D腹膜炎

A patient has a high fever with rigors, jaundice and right upper quadrant pain. Which condition is most likely?

1. AGastro-oesophageal reflux disease
2. BSimple biliary colic
3. CAscending cholangitis
4. DAcute appendicitis

Which exercise advice is recommended for intermittent claudication?

1. AComplete bed rest until the leg pain has gone for at least a month
2. BStopping walking at the very first twinge of pain each time
3. CSupervised walking until pain is near maximal, then rest and repeat
4. DWalking only on days when the legs feel warm and painless

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. AAn expected effect of the antibiotic
2. BA catheter-related deep vein thrombosis
3. CLymphoedema from lying in bed
4. DA local skin allergy to the dressing

哪种电解质模式是 Addison 病的典型表现？

1. A高钠低钾
2. B低钾低糖
3. C高钙低磷
4. D低钠高钾

A nurse teaches a carer to give buccal midazolam for prolonged seizures. Which statement shows a need for further teaching?

1. A"I will call an ambulance if the care plan tells me to."
2. B"I will put something between his teeth so he does not bite his tongue."
3. C"I will write down the time the seizure started and the time I gave the dose."
4. D"I will give it into the space between his gum and cheek."

After laparoscopic cholecystectomy, a patient has pain in the right shoulder. What is the most likely cause?

1. AGas used during surgery irritating the diaphragm
2. BAn allergy to the dressing on the wound
3. CA dislocated shoulder from patient positioning
4. DA heart attack during the operation

A nurse finds a dislodged sealed radiation source in the bed of a patient receiving brachytherapy. What should the nurse do?

1. AThrow it in the clinical waste bag
2. BUse long-handled forceps to put it in the lead container; report it
3. CLeave it in the bed until the end of the shift
4. DPick it up with gloved hands and put it in the nearest sharps bin quickly