Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

A patient with asthma uses a peak flow meter. A reading below 50% of personal best is in the red zone. Which statement shows correct understanding?

1. A“I will go for a short run to open up my lungs.”
2. B“I will stop all my inhalers until the reading is back up.”
3. C“I will wait until tomorrow morning to see if the reading gets better on its own.”
4. D“I will use my reliever inhaler and get emergency help straight away.”

A patient has a heart rate of 38/min, feels dizzy and has a blood pressure of 80/50 mmHg. Which drug is usually given first, as prescribed?

1. AAtropine
2. BDiltiazem
3. CMetoprolol
4. DDigoxin

A patient has leftover opioid tablets after surgery. Which advice about disposal is best?

1. ALeave them in the bathroom cabinet indefinitely
2. BGive them to a friend or relative who has back pain
3. CKeep them in an unlocked drawer at home in case of future pain
4. DReturn them to a pharmacy or an approved take-back site

A nurse finds an unknown liquid leaking from a container in the utility room, with a strong smell. What should the nurse do first?

1. ALeave the area, keep others out and alert the trained response team
2. BMove closer and smell it carefully to identify what the substance is
3. CPour water over it to dilute it
4. DMop it up with paper towels

A patient's potassium is unexpectedly 5.8 mEq/L. The sample was taken after the tourniquet was on for several minutes while the patient pumped their fist. What is the best interpretation?

1. ATourniquet time affects only the glucose result, not the potassium
2. BThe result confirms true hyperkalemia and needs no further checking
3. CThe result may be falsely high and should be repeated with better technique
4. DFist pumping lowers potassium, so the true level is even higher

Mengapakah kreatinin yang normal boleh mengelirukan pada warga emas yang lemah dengan jisim otot yang rendah?

1. AKreatinin yang normal sentiasa membuktikan fungsi buah pinggang yang normal
2. BOtot yang kurang menghasilkan kreatinin yang kurang, menyembunyikan fungsi buah pinggang yang berkurang
3. CWarga emas sentiasa mempunyai kreatinin lebih tinggi daripada orang muda
4. DParas kreatinin tidak bergantung pada jisim otot sama sekali

During a vesicant chemotherapy infusion, the patient reports burning and swelling at the cannula site. What should the nurse do first?

1. AApply a warm pack and continue the infusion
2. BStop the infusion straight away and follow the extravasation protocol
3. CFlush the cannula hard with saline
4. DIncrease the rate so that the infusion finishes as quickly as possible

A patient with severe ulcerative colitis develops abdominal distension, fever and tachycardia, and the number of stools falls. What complication should be suspected?

1. AToxic megacolon
2. BConstipation from dehydration
3. CRecovery from the colitis
4. DCoeliac disease

A patient is going home with a 24-hour Holter monitor. Which instruction is most important?

1. AStay in bed for the full 24 hours so the trace is clear
2. BRemove the monitor whenever symptoms occur and restart it
3. CKeep a diary of symptoms and activities with the times
4. DShower as normal with the monitor on

A patient regains a pulse after a ventricular fibrillation arrest that was probably caused by a heart attack. Which investigation is most urgent?

1. AAn abdominal ultrasound
2. BSpirometry
3. CA 12-lead ECG
4. DA lumbar puncture

A patient with Addison's disease takes fludrocortisone as well as hydrocortisone. Why?

1. ATo lower the blood pressure
2. BTo replace the missing adrenaline
3. CTo treat a low thyroid hormone level
4. DTo replace the missing aldosterone

A patient is being assessed for brain death (brainstem death). Which condition must be excluded before testing?

1. AEffects of sedative drugs or severe hypothermia
2. BA history of high blood pressure
3. CA previous episode of migraine
4. DA haemoglobin of 110 g/L (11 g/dL)

What is achalasia?

1. AWeakness of the lower oesophageal sphincter that allows reflux
2. BFailure of the lower oesophageal sphincter to relax on swallowing
3. CA tear at the junction of the oesophagus and the stomach
4. DInflammation of the oesophagus caused by a fungal infection

Dua hari selepas memulakan kemoterapi untuk limfoma gred tinggi, pengeluaran air kencing pesakit menurun; kalium 6.4 mmol/L, fosfat tinggi dan kalsium rendah. Apakah yang patut disyaki dan dilakukan oleh jururawat?

1. ADehidrasi biasa: galakkan cecair oral dan semak semula darah minggu depan
2. BKesan sampingan kemoterapi yang dijangka: tiada tindakan diperlukan sehingga kitaran seterusnya
3. CSindrom lisis tumor: buat eskalasi, mulakan pemantauan jantung dan jangka cecair IV
4. DTindak balas alergi: berikan antihistamin dan teruskan seperti biasa