Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

A patient on hemodialysis has an arteriovenous fistula in the left arm. Which instruction should the nurse give the nursing assistant?

1. ADo not measure blood pressure on the left arm
2. BMeasure blood pressure on the left arm only, every 4 hours
3. CKeep the left arm wrapped tightly in a bandage at night
4. DHelp the patient carry shopping bags on the left arm

A patient taking an SSRI is also given tramadol. A few hours later the patient is agitated, sweating and has a fever, jerking muscles and brisk reflexes. What is the most likely cause?

1. AOpioid withdrawal
2. BSerotonin syndrome
3. CAn anxiety attack
4. DNeuroleptic malignant syndrome

A patient is booked for an MRI scan. What must the nurse check beforehand?

1. AWhether the patient’s blood glucose has been in the normal range today
2. BWhether the patient has eaten a large meal recently
3. CWhether the patient has any metal implants or devices, such as a pacemaker
4. DWhether the patient has had a hearing test this year

A nurse discovers that an insulin infusion was programmed using the wrong drug concentration in the pump library. What should the nurse do first?

1. AReprogram the pump and finish the shift before reporting
2. BStop the infusion and check the patient’s blood glucose
3. CLeave it running and check the glucose at the next routine time
4. DDouble the rate to correct for the error

When is a peak level for an IV aminoglycoside such as gentamicin usually drawn?

1. AAbout 30 minutes after the infusion ends
2. BExactly 24 hours after the first dose
3. CJust before the next dose is started
4. DAt any time convenient for the patient

Pada petang selepas pembedahan, hemoglobin seorang pesakit telah jatuh daripada 12.5 g/dL kepada 8.1 g/dL (125 kepada 81 g/L), dan kadar denyutan jantung ialah 118/min. Apakah masalah yang paling mungkin?

1. APencairan normal selepas pembedahan yang tidak memerlukan tindakan
2. BDehidrasi
3. CKeadaan yang semakin pulih
4. DPendarahan

Why can a very low serum albumin contribute to oedema?

1. AIt increases the number of red cells
2. BIt makes the kidneys retain potassium
3. CIt lowers the oncotic pressure that holds fluid in the blood vessels
4. DIt raises the blood pressure in the capillaries and pushes fluid out

Pesakit sirosis dengan abdomen besar dan tegang menjalani parasentesis. Mengapakah albumin mungkin diberi?

1. AUntuk merawat jangkitan dalam cecair
2. BUntuk meningkatkan kalium dalam air kencing
3. CUntuk mengurangkan risiko disfungsi peredaran selepas pengeluaran cecair isi padu besar
4. DUntuk menghentikan hati menghasilkan lebih banyak hempedu

A patient is starting doxazosin, an alpha-blocker, for hypertension. Which advice is most important?

1. ATake the first dose at bedtime, as dizziness and fainting can occur
2. BStop it suddenly if the heart rate rises after the first few doses
3. CAvoid all potassium-containing foods
4. DTake it with a large glass of grapefruit juice to improve absorption

During drainage of a large pleural effusion, a patient starts coughing and feels tight in the chest. What should the nurse do?

1. AAsk the patient to cough harder to help the flow
2. BLie the patient flat until the drainage is complete
3. CStop or clamp the drainage and inform the doctor
4. DSpeed up the drainage to finish quickly

A man starts finasteride for an enlarged prostate. Which statement is correct?

1. AIt works within hours by relaxing the bladder muscle
2. BIt is used only for a few days at a time
3. CIt takes months to work; pregnant women must not handle broken tablets
4. DIt lowers the blood pressure, so dizziness is very common

The nurse has four renal patients. Which one needs to be seen first?

1. AA patient with mild itching from uraemia who wants a cream
2. BA patient with CKD asking about their phosphate binder
3. CA patient with a creatinine slightly above their usual level
4. DA patient with a potassium of 6.8 mmol/L who reports palpitations

After a spinal anaesthetic, which nursing check is particularly important?

1. APeak flow before and after each meal
2. BBlood glucose every 15 minutes overnight
3. CReturn of leg sensation and movement, and passing urine
4. DPupil reaction every five minutes for the next full day

A patient with cirrhosis takes spironolactone and furosemide. Which blood result should the nurse report before the next dose?

1. ASodium 138 mmol/L
2. BSodium 141 mmol/L
3. CPotassium 4.2 mmol/L
4. DPotassium 6.0 mmol/L