Prioritas & Delegasi ala NCLEX: paket kilat

A drowsy patient who has just returned from surgery starts to vomit. What should the nurse do first?

1. AGive a drink of water
2. BGive an oral anti-sickness tablet
3. CRaise the legs above the heart
4. DTurn the patient onto their side

A patient with diabetes takes propranolol. Which sign of hypoglycemia is most likely to still appear?

1. ATremor
2. BSweating
3. CTachycardia
4. DPalpitations

Apa yang harus dilakukan perawat setelah darah pasien tidak sengaja terciprat ke mata?

1. AMenyelesaikan prosedur, lalu melapor keesokan harinya
2. BMenggosok mata perlahan dengan tisu bersih dan kering untuk membuang darah terlebih dahulu
3. CMemberi tetes mata antibiotik dan tidak memberi tahu siapa pun
4. DSegera membilas mata dengan banyak air atau salin, lalu melapor

Pada pagi hari operasi, pasien mengatakan operasi dilakukan pada lutut kiri, tetapi formulir persetujuan menyebutkan lutut kanan. Apa yang harus dilakukan perawat?

1. AMengikuti formulir persetujuan, karena sudah ditandatangani
2. BBerhenti dan memberi tahu dokter bedah, agar lokasi dipastikan terlebih dahulu
3. CMenandai kedua lutut agar salah satunya dapat dioperasi
4. DMengikuti pasien, karena pasien paling tahu tubuhnya sendiri

Seorang pasien dengan aritmia ventrikel menunjukkan pola berputar (torsades de pointes) pada monitor. Elektrolit mana yang umum diberikan IV sebagai terapi?

1. AMagnesium sulfat
2. BKalium fosfat
3. CKalsium karbonat
4. DNatrium bikarbonat

A patient without symptoms has a TSH of 7,5 mIU/L on two occasions with a normal free T₄. Which term fits best?

1. ASubclinical hyperthyroidism
2. BOvert primary hypothyroidism
3. CSecondary hypothyroidism
4. DSubclinical hypothyroidism

Which group of symptoms suggests hypothyroidism?

1. ATiredness, weight gain and feeling cold
2. BExcessive thirst and passing large volumes of urine
3. CFever, neck stiffness and photophobia
4. DWeight loss, heat intolerance and tremor

Which action is most important in protecting a patient with severe neutropenia from infection?

1. AKeeping fresh flowers and plants in the room to help the patient's mood
2. BGiving routine intramuscular injections
3. CTaking rectal temperatures regularly
4. DStrict hand hygiene by everyone who has contact with the patient

Mengapa selang drainase dada umumnya tidak boleh diklem?

1. AUdara yang terperangkap dapat menumpuk dan menyebabkan pneumotoraks tension
2. BKlem melemahkan dan meretakkan selang secara permanen
3. CKlem menyebabkan air di segel menguap
4. DKlem membuat cairan keluar dari dada terlalu cepat

A patient with obstructive sleep apnoea who uses CPAP at home is having surgery. Which plan is safest after the operation?

1. ALeave the CPAP machine at home, as it is not needed while in hospital
2. BNurse the patient lying flat on their back to keep the airway open
3. CUse their CPAP machine and monitor closely, using opioids with caution
4. DGive extra opioids so the patient sleeps through the night

Which headache feature most suggests raised intracranial pressure from a brain tumour?

1. AA tight band across the forehead that eases with rest
2. BWorse on waking and on coughing, with vomiting
3. COnly present after reading for a long time
4. DBetter in the morning and worse with stress

Weeks after starting insulin, a patient with newly diagnosed type 1 diabetes needs much less insulin and has frequent mild hypos. What is the most likely explanation?

1. AA honeymoon phase, but insulin is still needed
2. BThe patient actually has type 2 diabetes
3. CThe insulin has gone off and should be replaced
4. DThe diabetes has been cured, so insulin can stop

What is achalasia?

1. AA tear at the junction of the oesophagus and the stomach
2. BFailure of the lower oesophageal sphincter to relax on swallowing
3. CWeakness of the lower oesophageal sphincter that allows reflux
4. DInflammation of the oesophagus caused by a fungal infection

Seorang pasien kanker payudara menjadi bingung, haus, dan konstipasi, dengan poliuria. Kegawatan onkologi mana yang harus dipertimbangkan?

1. AObstruksi vena kava superior
2. BHipoglikemia
3. CSindrom lisis tumor
4. DHiperkalsemia akibat keganasan