Prioritas & Delegasi ala NCLEX: paket kilat

A patient at 35 weeks of pregnancy with high blood pressure calls the clinic. Which symptom needs urgent assessment?

1. AMild ankle swelling at the end of the day
2. BBackache after a long walk
3. CA severe headache with blurred vision
4. DNeeding to pass urine more often

Temuan pasien mana yang tidak terduga dan perlu tindakan setelah reseksi prostat transuretra dengan irigasi kandung kemih kontinu?

1. ASpasme kandung kemih ringan yang mereda dengan obat antispasmodik yang diresepkan
2. BPerasaan ingin berkemih meskipun terpasang kateter
3. CUrine merah terang dengan bekuan dan aliran keluar kateter yang berkurang
4. DUrine merah muda muda yang menjadi lebih jernih sepanjang hari

How are neuromuscular blocking drugs, such as vecuronium, safely stored?

1. ANext to common IV antibiotics so they are easy to find
2. BMixed in the same bin as other high-use drugs
3. CSeparate from other drugs, with a warning that they cause paralysis
4. DIn the general stock cupboard with the other IV drugs and no special labels

During a disaster, the hospital needs to free beds quickly. Which patient is the best candidate for early discharge?

1. AA patient on a ventilator in the intensive care unit who is slowly improving
2. BA patient with ongoing chest pain awaiting cardiac tests
3. CA patient on an IV heparin infusion that is still being adjusted
4. DA patient admitted overnight for observation who is now stable with normal tests

A patient on warfarin for atrial fibrillation has a target INR of 2,0–3,0. How does the usual target for a patient with a mechanical mitral valve compare?

1. ALower, about 1,0–1,5
2. BHigher, about 2,5–3,5
3. CMuch higher, about 5,0–6,0
4. DThe same, 2,0–3,0

A patient has a continuous heparin infusion for a pulmonary embolism. A new nurse plans to adjust the infusion using today's INR of 1,1. What should the experienced nurse explain?

1. AThe INR of 1,1 means the heparin rate must be doubled at once
2. BHeparin is adjusted using the aPTT or anti-Xa level, not the INR
3. CThe INR is the correct test, and 1,1 means heparin is therapeutic
4. DHeparin needs no laboratory monitoring once the infusion is started

Seorang pasien yang menerima warfarin memiliki INR jauh di atas rentang target dan memar. Obat mana yang dapat diresepkan untuk membalikkan efeknya?

1. AProtamin sulfat
2. BNalokson
3. CAspirin
4. DVitamin K

Which sign is often a late finding in hypovolaemic shock in a young, previously fit adult?

1. AA slightly raised respiratory rate
2. BA rise in heart rate
3. CA fall in blood pressure
4. DCool peripheries

Menurut pedoman terkini, kapan oksigen diberikan kepada pasien dengan sindrom koroner akut?

1. ASelalu 15 L/menit, berapa pun saturasinya
2. BHanya setelah hasil troponin tersedia
3. CTidak pernah, karena oksigen merusak otot jantung
4. DHanya bila SpO₂ di bawah rentang target

A patient with crushing chest pain has ST elevation in leads V1–V4. Which coronary artery is most likely blocked?

1. AThe circumflex artery
2. BThe left anterior descending artery
3. CThe right coronary artery and its branches
4. DThe left subclavian artery

A patient with type 1 diabetes plans a long cycle ride. Which advice is most appropriate?

1. ATake an extra dose of rapid-acting insulin before setting off
2. BSkip breakfast so the exercise burns body fat
3. CCheck glucose before and after, and carry fast-acting carbohydrate
4. DAvoid checking glucose until the ride is over

A patient with nephrotic syndrome suddenly has loin pain, blood in the urine and a rise in creatinine. What is a likely cause?

1. AA simple bladder infection
2. BNormal fluctuation in the disease
3. CToo much dietary protein
4. DRenal vein thrombosis

What is a Curling's ulcer?

1. AA burn on the sole of the foot
2. BA stress ulcer of the stomach or duodenum after a major burn
3. CA leg ulcer caused by venous disease after long bed rest
4. DA pressure ulcer under a splint that has been left on too long

On day 5 after bowel resection, a patient has a fever, tachycardia and worsening abdominal pain, and the drain contains brown, faeculent fluid. What is most likely?

1. AA urinary tract infection
2. BA normal day 5 recovery
3. CPostoperative constipation
4. DAn anastomotic leak