Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

Semasa infusi antibiotik IV, seorang pesakit mengalami ruam gatal, berdehit dan suara serak. Apakah yang dilakukan oleh jururawat dahulu?

1. ADokumenkan tindak balas dalam carta
2. BHentikan infusi
3. CPerlahankan infusi kepada separuh kadar
4. DBeri difenhidramina oral

At 08:00 a nurse has four tasks. Which order is best?

1. ACheck the patient with a falling SpO₂, give insulin with breakfast, give routine medications, update care plans
2. BUpdate care plans, give insulin with breakfast, give routine medications, check the patient with a falling SpO₂
3. CGive insulin with breakfast, update care plans, check the patient with a falling SpO₂, give routine medications
4. DGive routine medications, check the patient with a falling SpO₂, update care plans, give insulin with breakfast

Why is blood glucose control important around the time of surgery?

1. AHigh glucose impairs white cell function and raises the risk of surgical site infection
2. BHigh glucose makes anesthetic drugs work for much longer and delays waking up
3. CLow glucose is needed around surgery so that the wound edges close more quickly
4. DGlucose levels only affect patients who have type 1 diabetes

In START triage at a mass-casualty incident, a casualty cannot walk, breathes 20 times a minute, has a radial pulse and follows simple commands. Which category applies?

1. ABlack (expectant or dead)
2. BGreen (minor)
3. CRed (immediate)
4. DYellow (delayed)

A healthy woman at 28 weeks of pregnancy has a mildly lower hemoglobin than before pregnancy, with a normal MCV and ferritin. What is the most likely explanation?

1. APregnancy hormones stop the bone marrow from making red cells
2. BThe fetus is destroying the mother's red cells in the circulation
3. CIron is being lost through the kidneys during the pregnancy
4. DPlasma volume rises more than red cell mass, diluting the blood

Seorang pesakit yang mengambil digoksin mempunyai paras 1.2 ng/mL, kalium 2.8 mEq/L dan denyutan ektopik ventrikel kerap yang baharu. Apakah tafsiran yang terbaik?

1. APesakit memerlukan dos digoksin yang lebih tinggi untuk mengawal irama
2. BDigoksin tidak mungkin puncanya, kerana paras berada dalam julat lazim
3. CKetoksikan mungkin berlaku, kerana kalium rendah meningkatkan kesan digoksin
4. DKalium tidak mempunyai kesan pada irama jantung

A nurse finds a patient lying on the floor beside the bed. What should be done first?

1. APhone the patient's family
2. BCheck the patient for injuries before moving them
3. CLift the patient straight back into bed so they are comfortable
4. DComplete the incident report form

A patient with several days of vomiting and diarrhoea has low blood pressure, low urine output and a rising creatinine. Which description fits best?

1. APost-renal acute kidney injury from obstruction, treated with a catheter
2. BIntrinsic kidney injury from glomerulonephritis, treated with high-dose steroids
3. CPre-renal acute kidney injury from poor perfusion, treated by restoring fluid volume
4. DChronic kidney disease, treated with long-term dialysis three times a week

A patient with heart failure takes furosemide once a day. When is the best time to take it?

1. AJust before the evening meal, with a large drink
2. BIn the morning, to avoid needing the toilet at night
3. CAt bedtime, so the effect lasts through the night
4. DWhenever the ankles look swollen, on those days only

A patient with severe COPD has increasing ankle oedema and a raised JVP, but no crackles and a normal left ventricle on echocardiography. Which condition is most likely?

1. AAortic stenosis
2. BCor pulmonale
3. CDeep vein thrombosis
4. DLeft ventricular failure

A patient with CKD is booked for a CT scan with iodinated contrast. Which measure helps protect the kidneys?

1. ARestricting all fluids for 24 hours before the scan
2. BGiving a dose of ibuprofen before the scan
3. CDoubling the dose of contrast for a clearer image
4. DGood hydration around the scan, often with IV fluids

Seorang pesakit dalam vest halo untuk patah tulang belakang servikal mengalami henti jantung. Apakah yang mesti tersedia dengan segera?

1. APapan keras untuk diselitkan di bawah vest
2. BBantal untuk menaikkan kepala dan bahu
3. CAlat untuk membuka bahagian hadapan vest bagi CPR
4. DGunting untuk memotong pin tengkorak

Which intervention most reduces pressure ulcer risk in an immobile patient?

1. AUsing a doughnut-shaped ring cushion
2. BRegular repositioning and a pressure-redistributing mattress
3. CKeeping the head of the bed raised at 90° all day
4. DMassaging red areas firmly at each turn to bring back the circulation

Seorang jururawat menumpahkan sedikit ubat sitotoksik di atas lantai. Apakah pendekatan yang betul?

1. AMengepnya dengan mop wad dan membilas mop dalam sluice
2. BMenggunakan kit tumpahan dengan PPE, membersihkan, membungkus sebagai sisa sitotoksik dan melaporkan
3. CMengelapnya dengan tuala kertas dan memasukkannya ke dalam tong sampah am
4. DMembiarkannya tersejat dan menjauhkan orang selama beberapa minit