Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

A patient is receiving opioids after surgery. Which finding usually comes before opioid-induced respiratory depression?

1. AA sudden rise in pain scores
2. BIncreasing sleepiness that is hard to rouse
3. CIncreased appetite and thirst
4. DA rise in blood pressure with flushed cheeks

A patient taking an MAO inhibitor antidepressant is taught about diet. Which statement shows a need for further teaching?

1. A“A sudden severe headache is a warning sign.”
2. B“I can still eat aged cheese and cured salami.”
3. C“I will check with the pharmacist before cold remedies.”
4. D“I will avoid tap beer and red wine.”

Dua pesakit dengan nama yang sangat serupa berada di unit yang sama. Apakah langkah keselamatan yang terbaik?

1. AMemanggil setiap pesakit dengan nama pertama sahaja
2. BMenandakan nama yang serupa dan menyemak dua pengenal pasti setiap kali
3. CMenggunakan nombor bilik untuk membezakan pesakit
4. DMemindahkan seorang daripada dua pesakit itu ke hospital lain

Seorang pesakit di ruang menunggu kecemasan batuk selama enam minggu, berpeluh pada waktu malam, kehilangan berat badan dan berdahak berdarah. Apakah yang patut dilakukan oleh jururawat dahulu?

1. AMeminta pesakit menunggu di ruang menunggu sehingga dipanggil
2. BMemulakan langkah berjaga-jaga sentuhan dengan gaun dan sarung tangan untuk kakitangan
3. CMenempatkan pesakit di dalam kubikel bersama dengan tirai ditutup
4. DMemakaikan pelitup muka kepada pesakit dan memindahkannya ke bilik pengasingan udara

A patient with a low clinical probability of deep vein thrombosis has a normal (negative) D-dimer. What is the best interpretation?

1. AA DVT is confirmed and anticoagulation is needed
2. BA pulmonary embolism is now certain to be present
3. CThe test is useless and should always be ignored
4. DA DVT is unlikely and can usually be ruled out

A patient with right upper abdominal pain from gallstones now has jaundice, a total bilirubin of 4.8 mg/dL (82 µmol/L) and a raised ALP. What is the most likely cause?

1. AA stone blocking the common bile duct
2. BHemolysis caused by the gallstones
3. CGilbert syndrome triggered by pain
4. DUncomplicated gallbladder inflammation

A dying patient can no longer drink and has a dry mouth. What is the most appropriate nursing care?

1. AInserting a nasogastric tube for fluids
2. BStarting a fast intravenous infusion to correct the dryness
3. CFrequent mouth care that keeps the lips and mouth moist
4. DLeaving the mouth alone to avoid disturbing them

Which nursing measure helps reduce raised intracranial pressure?

1. ALying the patient flat with the neck flexed forward on two pillows
2. BTilting the patient head-down
3. CRaising the head of the bed to about 30° with the head kept midline
4. DFrequent suctioning and encouraging strong coughing

Gabungan golongan ubat manakah yang meningkatkan kemandirian dalam kegagalan jantung dengan pecahan ejeksi berkurang?

1. APerencat ACE atau ARNI, penyekat beta, MRA dan perencat SGLT2
2. BDiuretik gelung sahaja pada dos tertinggi yang dapat ditoleransi
3. CNSAID, aspirin, statin dan diuretik tiazid
4. DDiuretik gelung, digoksin, nitrat dan penyekat saluran kalsium

The monitor shows a regular broad-complex tachycardia at 180/min. The patient is alert with BP 126/78 mmHg and no chest pain. What is the most appropriate plan?

1. ARecord a 12-lead ECG, call senior help and anticipate an antiarrhythmic
2. BStart chest compressions straight away and give a dose of IV adrenaline
3. CDeliver an unsynchronised shock immediately, before any other assessment
4. DReassure the patient, as this is a normal rhythm

An 82-year-old taking apixaban fell three weeks ago. Since then their family has noticed increasing confusion and headaches. Which condition is most likely?

1. ANormal ageing with mild memory loss
2. BSubarachnoid haemorrhage from an aneurysm
3. CAcute extradural haematoma
4. DChronic subdural haematoma

Seorang pesakit DKA semakin pulih: glukosa 9 mmol/L, keton 0.4 mmol/L, pH 7.36. Mereka sedang makan dan minum. Bagaimanakah insulin IV patut dihentikan?

1. AMenghentikan insulin IV sekarang dan memulakan insulin subkutan esok
2. BMemberikan insulin subkutan bersama makanan, kemudian menghentikan IV selepas pertindihan
3. CMenghentikan semua insulin, kerana ketoasidosis telah pulih sepenuhnya
4. DMemberikan insulin subkutan hanya jika glukosa meningkat melebihi 20 mmol/L

Fasa penyembuhan luka manakah yang melibatkan pembentukan tisu granulasi dan saluran darah baharu?

1. AFasa hemostasis (pembekuan)
2. BFasa pematangan
3. CFasa keradangan
4. DFasa proliferatif

A patient with diabetes on continuous enteral feeding and an insulin regimen has the feed stopped for a procedure. What is the main concern?

1. ADiarrhoea from stopping the feed suddenly
2. BRefeeding syndrome from too much glucose
3. CHypoglycaemia if insulin continues without the feed
4. DHyperglycaemia because the stomach is empty