Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

A patient taking clozapine reports a sore throat and fever. What is the priority action?

1. AHold the dose and report so the white cell count can be checked
2. BAdvise the patient to gargle with warm salt water and rest in bed
3. COffer throat lozenges and continue the usual dose
4. DIncrease the dose because the symptoms suggest a relapse

A child is admitted with a suspected Wilms tumor (nephroblastoma). Which instruction is most important for all staff?

1. AEncourage the child to play contact sports
2. BMeasure abdominal girth by pressing firmly
3. CDo not palpate the abdomen
4. DGive a warm bath with abdominal massage

Which room lighting is safest at night for a patient at high risk of falls?

1. AComplete darkness so the patient sleeps more deeply
2. BA low night light that lights the path to the bathroom
3. COnly the light from the television screen
4. DBright overhead lights left on all night in the room

A visitor is receiving an electric shock from a faulty lamp and is still touching it. What should the nurse do first?

1. AStart chest compressions straight away
2. BSwitch off the power or unplug the lamp without touching the person
3. CThrow water over the lamp to stop the current
4. DPull the visitor away from the lamp by the arm as quickly as possible

An older adult with chronic kidney disease starts trimethoprim-sulfamethoxazole for a urinary tract infection. Which electrolyte should be monitored closely?

1. APotassium, because trimethoprim can raise it
2. BChloride, because the drug causes chloride loss
3. CSodium, because the drug causes heavy sodium retention
4. DCalcium, because the drug binds calcium in the gut

A patient on clozapine for 2 years has been stable. Which statement shows a need for further teaching?

1. A"I'll tell other doctors that I take clozapine"
2. B"I'll keep all my scheduled blood test visits"
3. C"I can stop my blood tests since I feel well"
4. D"I'll report a sore throat or fever at once"

Which features suggest Cushing's syndrome?

1. AWeight gain around the trunk, a rounded face and thin, easily bruised skin
2. BDark skin, low blood pressure, salt craving and a low blood sodium level
3. CWeight loss, heat intolerance, tremor and protruding eyes
4. DCoarse facial features and very large hands and feet

A patient with small cell lung cancer has hyponatraemia, concentrated urine and no signs of dehydration. Which condition and first measure fit best?

1. ASIADH, often managed first with fluid restriction
2. BCushing's syndrome, managed with potassium
3. CDehydration, managed with an IV fluid bolus
4. DDiabetes insipidus, managed with extra fluids

Why is a beta-blocker started at a low dose and increased slowly in heart failure?

1. AIt must be stopped as soon as symptoms improve
2. BIt works only if the dose is never changed after the first day
3. CIt can briefly worsen symptoms before long-term benefit appears
4. DIt is safe only at the highest possible dose from the very start

An older inpatient develops sudden fever, muscle aches and a dry cough during the winter influenza season. Which plan is most appropriate?

1. AWait a week to see whether the symptoms settle before testing
2. BIsolate with droplet precautions, test and expect early antivirals
3. CIsolate only if they develop a rash
4. DLeave them in the open bay and give a course of antibiotics only

A patient has radioactive iodine treatment for hyperthyroidism. Which advice is correct?

1. AStart breastfeeding again the next day
2. BLimit close contact with children and pregnant women for a time
3. CStay in strict isolation in hospital for several months
4. DThere are no precautions, because the dose is tiny

A patient with a brain injury has a mean arterial pressure of 80 mmHg and an ICP of 25 mmHg. How should the nurse interpret this?

1. AThe cerebral perfusion pressure is 55 mmHg, below the usual target
2. BThe ICP cannot affect brain perfusion if the blood pressure is normal
3. CThe cerebral perfusion pressure is 105 mmHg, which is too high
4. DThe cerebral perfusion pressure is 80 mmHg, which is normal

Which practice is correct when giving parenteral nutrition through a central line?

1. AGive other IV drugs through the same lumen to save time
2. BDisconnect and reconnect the line without cleaning the hub
3. CLet the bag hang at room temperature for several days
4. DUse a dedicated lumen and strict aseptic technique

At the end of an operation, the final count shows one swab missing. What should happen?

1. ATell the surgeon, search, and X-ray if it is not found
2. BRecord the count as correct to avoid a delay
3. CLet the patient leave and search the theatre later
4. DClose the wound, as the swab was probably thrown away