Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

A patient with a valid do-not-resuscitate order (DNR; called DNACPR in the UK) stops breathing and has no pulse. What should the nurse do?

1. AStart CPR and stop when the family arrives
2. BFollow the DNR order and do not start CPR
3. CStart chest compressions but not rescue breaths
4. DCall the cardiac arrest team and let them decide

Which assignment by the charge nurse should be changed?

1. AAn LPN/LVN is assigned to give oral medications to stable patients
2. BA nursing assistant is assigned to help several stable patients with their meals
3. CAn RN is assigned to a patient receiving a blood transfusion
4. DAn LPN/LVN is assigned to admit a new patient from the emergency department

Why is “QD” (once daily) on The Joint Commission’s “Do Not Use” list?

1. AIt means “every day at bedtime” in some hospitals
2. BIt can be misread as QID or QOD, so the drug is given too often or too rarely
3. CIt is only allowed for intravenous medicines
4. DIt is a Latin abbreviation, and only plain English abbreviations may be used

During a procedure, a nurse sees that the team is about to start without a time-out. What should the nurse do?

1. AWait and raise the issue after the procedure is finished
2. BReport it to the manager at the end of the week
3. CSay nothing, because the surgeon is responsible for the procedure
4. DSpeak up clearly and stop the start until the time-out is done

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

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

A patient in hyperosmolar hyperglycemic state has a glucose of 1,050 mg/dL (58 mmol/L), very dry mucous membranes and a fast pulse. Which treatment is usually the first priority?

1. AStrict fluid restriction
2. BAn IV bolus of sodium bicarbonate
3. CLarge-volume IV fluid replacement
4. DOral glucose-lowering tablets

What is the most common cause of hypernatraemia in frail older inpatients?

1. AEating too much salt in one meal
2. BTaking too many vitamins
3. CToo much exercise
4. DNot drinking enough water

A potassium result of 6.9 mmol/L comes back on a well patient with a normal ECG, and the laboratory reports that the sample was haemolysed. What is the best action?

1. AGive IV insulin and glucose straight away
2. BIgnore the result because the patient looks well and the ECG is normal
3. CRepeat the blood test promptly, as haemolysis can falsely raise potassium
4. DStart a potassium supplement

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

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

During a cardiac arrest, the monitor shows an organised rhythm, but there is no pulse. What should the team do?

1. AGive adenosine to slow the rhythm down
2. BDeliver an unsynchronised shock at once and then check the pulse
3. CStop CPR, because an organised rhythm on the monitor means recovery
4. DContinue CPR and give adrenaline (epinephrine), as the rhythm is non-shockable

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 drowsy patient's glucose meter shows "HI". What should the nurse do?

1. ATreat it as very high, check ketones and escalate
2. BAssume the meter is broken and recheck tomorrow
3. CGive glucose gel in case the reading is wrong
4. DRecord "normal" in the notes because no number appears

Corak elektrolit manakah yang tipikal bagi sindrom lisis tumor?

1. AKalium dan fosfat rendah dengan kalsium tinggi
2. BKalium, fosfat dan asid urik tinggi; kalsium rendah
3. CKalium rendah, fosfat rendah dan asid urik rendah
4. DNatrium tinggi dan kalsium tinggi dengan aras asid urik rendah

Which medicine commonly needs enteral feeds paused before and after each dose because the feed reduces its absorption?

1. AOmeprazole liquid
2. BParacetamol
3. CPhenytoin
4. DLactulose