Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

On the first day after abdominal surgery, a patient has a temperature of 37.9 °C and reduced breath sounds at the lung bases. Which nursing action is most helpful?

1. ARestrict oral fluids so that the lungs do not fill up with extra fluid
2. BKeep the patient lying flat in bed to rest the incision fully
3. CEncourage deep breathing, coughing and use of the incentive spirometer
4. DGive a cough suppressant so that the incision is not strained

A nurse must care for a patient with a radioactive implant. Which approach best limits the nurse’s exposure?

1. AStand close to the patient to finish care faster
2. BSpend longer in the room each time but visit less often during the shift
3. CWear a surgical mask to block the radiation
4. DLimit time in the room, keep as far away as possible and use shielding

Seorang pesakit dengan tuberkulosis pulmonari aktif perlu pergi ke jabatan radiologi. Bagaimanakah pesakit patut diangkut?

1. AMemakai respirator N95 yang belum diuji kesesuaiannya
2. BMemakai sarung tangan dan gaun, tanpa memerlukan pelitup muka
3. CMemakai pelitup muka pembedahan, dengan radiologi dimaklumkan lebih awal
4. DTanpa pelitup muka, kerana koridor itu berpengudaraan baik dan pendek

A nurse often skips barcode scanning to save time, as many colleagues do. In a just culture, how is this behavior classed?

1. AAt-risk behavior, managed by coaching and fixing the system pressures behind it
2. BSimple human error, managed only by consoling the nurse and moving on
3. CReckless behavior, managed by immediate dismissal and reporting to the licensing board
4. DAcceptable behavior, because it is common on the unit

Seorang pesakit dengan aritmia ventrikel menunjukkan corak berpusing (torsades de pointes) pada monitor. Elektrolit manakah yang lazim diberikan secara IV sebagai rawatan?

1. AKalsium karbonat
2. BMagnesium sulfat
3. CKalium fosfat
4. DNatrium bikarbonat

At the start of a shift, the nurse reviews four new results. Which patient needs attention first?

1. APotassium 5.2 mEq/L in a patient with stable chronic kidney disease
2. BGlucose 180 mg/dL (10 mmol/L) after a meal in a patient with diabetes
3. CSodium 119 mEq/L in a patient with new confusion and vomiting
4. DHemoglobin 11.0 g/dL (110 g/L) in a patient with rheumatoid arthritis

A patient with COPD and known carbon dioxide retention needs a nebulised bronchodilator. How should it usually be given?

1. ADriven by high-flow oxygen at 15 L/min for as long as possible
2. BOnly with the patient lying flat
3. CWithout monitoring oxygen saturation
4. DDriven by compressed air, with oxygen given separately if needed

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. APre-renal acute kidney injury from poor perfusion, treated by restoring fluid volume
2. BChronic kidney disease, treated with long-term dialysis three times a week
3. CIntrinsic kidney injury from glomerulonephritis, treated with high-dose steroids
4. DPost-renal acute kidney injury from obstruction, treated with a catheter

Seorang pesakit kegagalan jantung bertanya mengapa garam dihadkan. Penjelasan manakah yang betul?

1. ANatrium menyebabkan badan menahan air, yang menambah kongesti
2. BNatrium meningkatkan kadar jantung semasa tidur
3. CNatrium secara langsung melemahkan otot jantung yang mengecut
4. DNatrium menghalang tablet diuretik daripada diserap dengan betul

A patient with pneumonia has a heart rate of 118/min, BP 86/50 mmHg, RR 28/min and a high lactate. Sepsis is recognised. Which action should not be delayed?

1. ATake blood cultures and give IV antibiotics within the first hour
2. BDelay fluids until a chest X-ray has been reported
3. CWait for the sputum culture result before choosing an antibiotic
4. DGive oral antibiotics and reassess the next day

After pressing the plunger of an insulin pen, what should the patient do?

1. AKeep the needle in the skin for about 10 seconds
2. BInject a second dose straight away to be sure
3. CPull the needle out at once and rub the site firmly
4. DLeave the needle on the pen for the next injection

Which task can the registered nurse delegate to a trained healthcare assistant (nursing assistant)?

1. AAssessing a confused patient whose glucose is 2.6 mmol/L (47 mg/dL)
2. BChecking pre-meal glucose and reporting results out of range
3. CTeaching a new patient how to inject insulin
4. DDeciding the dose of correction insulin from the glucose result

Which early symptoms suggest local anaesthetic systemic toxicity?

1. ATingling around the mouth, a metallic taste and tinnitus
2. BIncreased hunger and thirst over several hours, with a dry mouth
3. CA red rash only at the injection site, with no other symptoms
4. DMild itching of the feet the next day

A patient taking IV antibiotics has three unexplained loose stools in 24 hours. What should the nurse do first?

1. AIsolate the patient and send a stool sample for testing
2. BWait two days to see if the diarrhoea settles
3. CGive loperamide after each loose stool and continue as usual
4. DMove the patient to a bay with other patients to watch them closely