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 chest compressions but not rescue breaths
2. BStart CPR and stop when the family arrives
3. CCall the cardiac arrest team and let them decide
4. DFollow the DNR order and do not start CPR

A marathon runner is confused, with a temperature of 41 °C and hot skin. What is the priority?

1. AWrapping the runner in a blanket to prevent shivering
2. BGiving an antipyretic tablet and waiting for it to work
3. CRapid cooling while supporting airway and circulation
4. DAsking the runner to rest in the shade and drink slowly

Pengimbas kod bar memberi amaran bahawa ubat tidak sepadan dengan rekod pesakit. Apakah yang patut dilakukan oleh jururawat?

1. ABerhenti dan ketahui puncanya sebelum memberikan ubat
2. BMengimbas gelang tangan pesakit lain
3. CMemberikan ubat dan melaporkan amaran itu kemudian pada syif yang sama
4. DMengatasi amaran dan memberikan ubat

A nurse has a needlestick from a patient known to have hepatitis C. Which statement about management is correct?

1. AHepatitis C immune globulin is given within 24 hours, followed by a booster dose
2. BNo follow-up is needed because hepatitis C does not spread by needles
3. CThe hepatitis C vaccine series is started at once, with a booster dose six months later
4. DThere is no preventive drug, so baseline and follow-up testing are done to detect infection early

An older adult with chronic kidney disease takes glyburide (glibenclamide, a sulfonylurea) and has repeated low glucose readings. Why is this a concern?

1. AThe drug and its metabolites build up and cause long lows
2. BThe drug causes high potassium that lowers the glucose
3. CThe drug makes the glucose meter read falsely low
4. DThe drug stops working entirely when the kidneys fail

A patient with severe hypertriglyceridemia has a measured sodium of 128 mEq/L, but a measured serum osmolality is normal, and the patient has no symptoms. What is the most likely explanation?

1. ATrue hyponatremia from SIADH that needs fluid restriction
2. BHyponatremia caused by drinking far too much water
3. CHyponatremia caused by severe hyperglycemia in diabetes
4. DPseudohyponatremia, an artifact caused by very high lipids

Pesakit yang mengambil digoksin mengalami loya, nadi 48/min dan mengadu segala-galanya kelihatan kuning. Apakah yang patut disyaki?

1. AHipoglisemia
2. BHipertiroidisme
3. CKetoksikan digoksin
4. DKesan sampingan normal yang tidak memerlukan tindakan

A few hours after cardiac surgery, a patient has low blood pressure, a raised jugular venous pressure and quiet, muffled heart sounds. What should be suspected?

1. AHypovolaemia from dehydration
2. BCardiac tamponade
3. CPneumonia
4. DHyperkalaemia

A patient has a heart rate of 36/min with hypotension and dizziness. Which drug is usually the first choice?

1. AIntravenous adenosine
2. BOral bisoprolol
3. CIntravenous atropine
4. DIntravenous amiodarone

A patient with a valid, documented do-not-attempt-CPR decision (DNACPR in the UK, DNR or DNAR in the US) is found in cardiac arrest. What should the nurse do?

1. ANot start CPR, call for support, and provide dignity and comfort
2. BCall the arrest team and let them decide whether to resuscitate
3. CStart full CPR because the patient's family is not present
4. DStart CPR but use only chest compressions

Pernyataan manakah tentang insulin basal bertindak panjang seperti glargin yang betul?

1. AIa mempunyai kemuncak tindakan yang tajam kira-kira 30 minit selepas suntikan
2. BIa dicampur dengan insulin bertindak pantas dalam picagari yang sama
3. CIa diberikan hanya selepas makan besar untuk menampung karbohidrat
4. DDalam diabetes jenis 1 ia diteruskan walaupun pesakit tidak makan

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. BAn oral antihistamine such as cetirizine
3. CA benzodiazepine such as diazepam
4. DOral paracetamol (acetaminophen) alone

Which statement about giving medicines through a feeding tube is correct?

1. AMedicines can be added to the bag of feed
2. BTubes do not need flushing between medicines
3. CModified-release tablets should not be crushed
4. DAll tablets can be crushed together and given at once

An incontinent patient has diffuse, shiny, red and broken skin in the natal cleft and buttocks with irregular edges, not over a bony prominence. What is most likely?

1. AA category 4 pressure ulcer over the sacrum
2. BA full-thickness burn
3. CAn arterial ulcer caused by poor circulation
4. DIncontinence-associated dermatitis