Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

A patient is receiving opioids after surgery. Which finding usually comes before opioid-induced respiratory depression?

1. AA rise in blood pressure with flushed cheeks
2. BIncreasing sleepiness that is hard to rouse
3. CA sudden rise in pain scores
4. DIncreased appetite and thirst

A patient with Guillain-Barré syndrome has weakness that is spreading up from the legs. Which assessment has the highest priority?

1. ASkin condition over the heels
2. BBreathing strength, such as vital capacity and the ability to cough
3. CThe patient’s mood and coping
4. DMuscle strength in the feet and ankles at the start of each morning

Which practice reduces back strain when a nurse moves a patient or heavy object?

1. AKeep the load close to the body and avoid twisting
2. BStand with the feet close together for balance
3. CHold the load at arm’s length to keep it steady
4. DBend at the waist and keep both knees straight

A child with fever, cough, red eyes and a spreading rash is in a clinic waiting room. Measles is suspected. What should the nurse do first?

1. APut a mask on the child and move them into an airborne isolation room
2. BAsk the family to wait in the main waiting room until the child is called in
3. CGive the child an antipyretic and continue triage
4. DSend the child home to rest without an assessment

Apart from the lithium level, which tests are monitored regularly in long-term lithium therapy?

1. AINR and the platelet count
2. BLiver enzymes and serum amylase
3. CKidney function and thyroid function
4. DTroponin and creatine kinase (CK)

The nurse teaches a patient who is collecting a 24-hour urine sample at home. Which statement shows a need for further teaching?

1. A"If I forget to save one void, I'll just carry on to the end"
2. B"I'll ask whether any foods or drugs should be avoided first"
3. C"I'll empty my bladder at the end time and add that urine"
4. D"I'll keep the container cool as the laboratory told me to"

Which group of features is typical of nephrotic syndrome?

1. ASevere loin pain and fever
2. BBlood in the urine, high blood pressure and reduced urine output only
3. CPolyuria, thirst and weight loss
4. DHeavy proteinuria, low serum albumin and oedema

After a high spinal cord injury, a patient has low blood pressure with a slow heart rate and warm, dry skin. What is most likely?

1. ACardiac tamponade
2. BNeurogenic shock
3. CSeptic shock
4. DHypovolaemic shock

After an acute coronary syndrome, a patient with a normal cholesterol level is prescribed a high-intensity statin. Why?

1. AStatins are needed only if the cholesterol level is very high
2. BStatins are given after an ACS mainly to lower the blood pressure
3. CStatins work as painkillers for chest pain
4. DStatins reduce further events whatever the starting cholesterol

A nurse reviews inhaler use with a patient who has asthma and uses a separate steroid preventer inhaler and a salbutamol reliever. Which statement shows a need for further teaching?

1. A"I use my steroid inhaler when I start to wheeze."
2. B"I use my steroid inhaler every day, even when I feel well."
3. C"I rinse my mouth after the steroid inhaler."
4. D"I carry my blue reliever inhaler with me."

Seorang pesakit AKI mempunyai kateter urin yang tidak mengalirkan apa-apa. Semakan pantas di sisi katil manakah yang membantu menyingkirkan punca pascarenal?

1. AMemberikan bolus besar cecair IV serta-merta
2. BMemeriksa kateter untuk lipatan atau sekatan dan melakukan imbasan pundi kencing
3. CMenghantar sampel air kencing untuk kultur dan menunggu keputusan makmal
4. DMenggalakkan pesakit minum dua liter air

Selepas pembedahan, seorang pesakit penyakit Graves mempunyai suhu 39.8 °C, kadar jantung 160/min, kegelisahan dan muntah. Set rawatan manakah yang paling sesuai?

1. ALevotiroksin dan selimut hangat untuk menenangkan menggigil
2. BSekatan cecair dan diuretik gelung untuk merawat takikardia
3. CPenyejukan, penyekat beta, ubat antitiroid, kemudian iodin dan steroid
4. DAspirin untuk demam dan semakan oleh GP dalam seminggu

Why is the Lund and Browder chart preferred to the rule of nines for children?

1. AIt is used only for burns of the hands
2. BIt is faster to use than any other method of estimation
3. CIt adjusts for body proportions that change with age
4. DIt counts superficial burns as well

A patient arrives in recovery with a temperature of 35.2 °C and is shivering. What is the most appropriate action?

1. ASend the patient to the ward to warm up there under extra blankets
2. BRemove all blankets to let the body adjust
3. CStart active warming and monitor the temperature
4. DGive cold IV fluids to settle the shivering