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. CIncrease the dose because the symptoms suggest a relapse
4. DOffer throat lozenges and continue the usual dose

Laporan pembantu jururawat manakah yang patut ditindaki dahulu oleh jururawat?

1. APesakit yang berehat di katil meminta pan katil
2. BSelepas pelakuran tulang belakang lumbar pagi ini, tidak dapat merasa atau menggerakkan kaki
3. CPesakit pneumonia telah batuk kahak kuning
4. DPesakit diabetes berkata kakinya sering terasa kebas-kebas, seperti kebiasaannya

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

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

In START triage, a casualty cannot walk and is breathing 36 times a minute. Which category applies?

1. ABlack (expectant or dead)
2. BGreen (minor)
3. CYellow (delayed)
4. DRed (immediate)

Seorang pesakit menerima enoksaparin subkutan (heparin berat molekul rendah). Pernyataan manakah tentang pemantauan yang betul?

1. ATiada aPTT rutin; platelet dan fungsi buah pinggang diperiksa sebaliknya
2. BINR digunakan untuk melaraskan setiap dos, seperti warfarin
3. CTiada sebarang ujian darah pun diperlukan
4. DaPTT mesti diperiksa setiap 6 jam untuk melaraskan dos

A patient with diabetes and chronic kidney disease had a CT scan with IV contrast. Two days later, the creatinine has risen from 1.4 to 2.0 mg/dL (124 to 177 µmol/L). Which action is most appropriate?

1. AGive extra metformin, because the glucose rises after contrast
2. BReport it, monitor urine output and hold metformin until reviewed
3. CRestrict all fluids to protect the kidneys from more contrast
4. DIgnore it, because contrast never affects kidney function

A patient without diabetes is started on high-dose prednisolone. Why might capillary blood glucose be monitored?

1. ASteroids can raise the blood glucose
2. BSteroids destroy the pancreas
3. CSteroids make glucose meters inaccurate
4. DSteroids always cause hypoglycaemia

Pesakit yang hampir meninggal dunia mempunyai pernafasan berbunyi dan bergelugut akibat rembesan di kerongkong dan tidak sedarkan diri. Pendekatan manakah yang sesuai?

1. ABeritahu keluarga bahawa pesakit tercekik dan memerlukan ventilasi
2. BTukar posisi, pertimbangkan ubat antirembesan yang dipreskripsikan dan sokong keluarga
3. CMulakan cecair intravena pantas untuk mencairkan dan membersihkan rembesan
4. DMulakan sedutan orofaring dalam setiap 10 minit sepanjang malam

Why is a higher level of HDL cholesterol considered protective?

1. AHDL lowers the blood pressure directly
2. BHDL is converted into vitamin D in the walls of the arteries
3. CHDL thins the blood in the same way as an anticoagulant
4. DHDL carries cholesterol from the tissues back to the liver

Thirty minutes after extubation, a patient develops a high-pitched noise on breathing in and is anxious. SpO₂ is falling. What should the nurse do?

1. AEncourage the patient to sleep it off and recheck them in an hour
2. BGive a large drink of cold water to soothe the throat and settle it
3. CLay the patient flat and reassure them
4. DSit the patient up, give oxygen and call for urgent airway help

Why is levodopa combined with carbidopa (or benserazide)?

1. ATo prevent tolerance from developing to levodopa over time
2. BTo make levodopa cross into the brain more slowly and evenly
3. CTo add a separate effect that reduces the resting tremor directly
4. DTo stop levodopa being converted to dopamine outside the brain

A patient with renal colic has normal kidney function and no other contraindications. Which drug is usually the first choice for pain?

1. AAn NSAID such as diclofenac
2. BA benzodiazepine such as diazepam
3. COral paracetamol (acetaminophen) alone
4. DAn oral antihistamine such as cetirizine

Which early symptoms suggest local anaesthetic systemic toxicity?

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

An older patient on regular opioids has small amounts of liquid stool leaking all day, but has not had a formed bowel movement for 6 days. What is the most likely cause?

1. AA flare of ulcerative colitis
2. BNormal stool pattern on opioids
3. CAcute infective gastroenteritis
4. DFaecal impaction with overflow