Prioritas & Delegasi ala NCLEX: paket kilat

A parent of a child with influenza talks with the nurse. Which statement shows a need for further teaching?

1. A“I will give my child plenty of fluids.”
2. B“I will keep my child home from school and away from others while unwell.”
3. C“I will give my child aspirin to bring the fever down.”
4. D“I will call if my child has trouble breathing.”

A provider asks a nurse to perform a procedure that is outside the nurse’s scope of practice. What should the nurse do?

1. AAsk a nursing assistant to do it instead
2. BDo it just this once and promise the provider not to do it again
3. CDo it, because the provider gave the instruction
4. DDecline, explain why and suggest who can safely do it

Before a defibrillator shock is delivered, what must the person operating it do?

1. AAsk a colleague to hold the paddles in place
2. BCall “all clear” and check that nobody is touching the patient or bed
3. CHold the patient’s hand to keep them still
4. DKeep the oxygen mask on the patient’s face, held against the chest

A nurse teaches a patient going home with an MRSA wound infection. Which statement shows a need for further teaching?

1. A“I will put used dressings in a sealed bag before throwing them out.”
2. B“I will keep the wound covered with a clean, dry dressing.”
3. C“I can share towels with my family if I wash them every week.”
4. D“I will wash my hands after touching my dressing.”

Why must vitamin B₁₂ deficiency be ruled out before treating macrocytic anemia with folic acid alone?

1. AFolic acid can fix the anemia while B₁₂-related nerve damage continues
2. BFolic acid makes B₁₂ deficiency anemia much worse within a few days
3. CFolic acid causes iron overload when B₁₂ levels are low
4. DFolic acid blocks the absorption of all B₁₂ from the diet

A patient with acute pancreatitis has a rising BUN, a falling calcium and a glucose of 250 mg/dL (13,9 mmol/L) over the first 48 hours. What do these results suggest?

1. AIncreasingly severe pancreatitis
2. BA resolving, mild pancreatitis
3. CAn unrelated new kidney stone
4. DA lab error from lipemic samples

An arterial blood gas shows a low pH, a high PaCO₂ and a normal bicarbonate. What does this show?

1. ARespiratory alkalosis
2. BRespiratory acidosis
3. CMetabolic alkalosis
4. DMetabolic acidosis

Tak lama setelah transfusi dimulai, seorang pasien menjadi sesak napas, mengi, dan hipotensi disertai pembengkakan wajah. Apa yang harus dilakukan perawat terlebih dahulu?

1. ABerikan parasetamol dan antihistamin lalu lanjutkan transfusi
2. BHabiskan unit dengan cepat agar waktu paparan sesingkat mungkin
3. CHentikan transfusi, pertahankan akses IV, dan panggil bantuan segera
4. DPerlambat laju transfusi dan periksa ulang observasi dalam satu jam

Septic shock belongs to which category of shock?

1. AObstructive shock
2. BHypovolaemic shock
3. CCardiogenic shock
4. DDistributive shock

Seorang pasien PPOK pulang dengan oksigen jangka panjang. Poin edukasi mana yang paling penting untuk keselamatan?

1. AGunakan vaselin untuk menenangkan lubang hidung yang kering
2. BSimpan tabung cadangan di samping kompor
3. CJangan merokok atau membiarkan api terbuka di dekat oksigen
4. DNaikkan aliran setinggi yang dibutuhkan saat sesak napas

A patient has radioactive iodine treatment for hyperthyroidism. Which advice is correct?

1. AStart breastfeeding again the next day
2. BStay in strict isolation in hospital for several months
3. CLimit close contact with children and pregnant women for a time
4. DThere are no precautions, because the dose is tiny

A patient on carbamazepine is admitted confused, with a sodium of 121 mmol/L. Which explanation is most likely?

1. AConfusion is a normal, expected effect of carbamazepine and is unrelated to sodium
2. BCarbamazepine can cause hyponatraemia through an SIADH-like effect
3. CThe low sodium proves the patient has stopped taking the drug
4. DCarbamazepine causes salt loss through severe diarrhoea

Why are urinary catheters removed as early as possible after surgery?

1. ABecause patients cannot drink normally while a catheter is in place
2. BBecause the catheter stops the bowel working
3. CTo reduce the risk of catheter-associated infection
4. DBecause catheters always cause kidney stones

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. AGive a diuretic without discussing it
2. BStop all IV fluids completely and remove the catheter
3. CDiscuss reducing the fluid rate with the team
4. DIncrease the fluid rate to keep the output high