Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

A patient receiving an aminoglycoside antibiotic, such as gentamicin, reports ringing in the ears. What should the nurse do?

1. AReassure the patient that it is a normal effect
2. BHold the next dose and report it promptly
3. CGive the next dose early to finish the course
4. DAdvise the patient to use ear drops

Seorang pesakit dengan pendarahan GI atas mempunyai kadar denyutan jantung 128/min dan tekanan darah 84/50 mmHg. Semua ini ditetapkan. Yang manakah dimulakan dahulu oleh jururawat?

1. ACecair IV atau darah melalui kanula bersaiz besar
2. BInfusi perencat pam proton IV
3. CTablet zat besi oral
4. DMenempah endoskopi diagnostik untuk pagi esok

Apakah yang patut dilakukan oleh jururawat selepas darah pesakit terpercik ke mata secara tidak sengaja?

1. AMenggosok mata perlahan-lahan dengan tisu bersih dan kering untuk membuang darah dahulu
2. BMenyiapkan prosedur, kemudian melapor pada hari berikutnya
3. CMembilas mata serta-merta dengan banyak air atau salin, kemudian melapor
4. DMenitiskan titis mata antibiotik dan tidak memberitahu sesiapa

A patient asks for a pain tablet. The record shows none has been given, but the patient says, “The other nurse gave me one earlier.” What should the nurse do?

1. AGive the tablet, because the record shows none was given
2. BTell the patient they must be confused
3. CGive half a tablet now, to be safe, and the other half later if needed
4. DCheck with the other nurse and the records before giving another dose

A patient with hepatic encephalopathy is receiving lactulose. Which finding best shows that the treatment is effective?

1. AA rising serum ammonia with a slower flapping tremor
2. BNo bowel movement for 2 days and calm sleep
3. CTwo to three soft stools a day and clearer thinking
4. DSix to eight watery stools a day with dizziness

Kalsium keseluruhan seorang pesakit ialah 7.9 mg/dL (2.0 mmol/L), dengan albumin 2.4 g/dL (24 g/L) dan tiada gejala. Ujian manakah yang paling baik menjelaskan sama ada hipokalsemia sebenar wujud?

1. AKalsium terion
2. BHbA1c
3. CNatrium serum
4. DGraviti tentu air kencing

A patient's low potassium does not improve despite potassium replacement. Which other electrolyte should be checked?

1. APhosphate
2. BSodium
3. CMagnesium
4. DChloride

A patient with poorly controlled hyperthyroidism develops a high fever, very fast heart rate, agitation and vomiting during an infection. What is likely?

1. AMyxoedema coma
2. BThyroid storm
3. CHypoglycaemia
4. DAddisonian crisis

Which finding shows that long-standing hypertension has caused target organ damage?

1. AA heart rate of 72/min
2. BLeft ventricular hypertrophy on the ECG
3. CA normal fasting glucose
4. DClear lung fields on the chest X-ray

An older patient with three rib fractures is breathing shallowly and refuses to cough because of pain. What is the priority intervention?

1. AEffective analgesia so they can breathe deeply and cough
2. BWithhold analgesia to avoid depressing breathing
3. CKeep the patient flat and still in bed until the pain settles
4. DStrap the chest tightly with bandages to stop the ribs moving

For which patient would the nurse question an order for pioglitazone?

1. AA patient with heart failure
2. BA patient with hypothyroidism
3. CA patient with asthma
4. DA patient with an allergy to latex

A patient had a witnessed tonic-clonic seizure. Afterwards their left arm is weak, and the weakness improves over the next few hours. What is the best interpretation?

1. APossible postictal (Todd's) paresis, but a stroke must still be excluded
2. BA sign that the patient is pretending to be weak
3. CNormal postictal tiredness that needs no further assessment or imaging at all
4. DCertainly a stroke, so the seizure can be ignored

Which group of findings suggests obstruction of the bile duct?

1. ARed urine, black stools and a high blood glucose
2. BPale urine, dark stools and a flapping tremor
3. CJaundice, dark urine, pale stools and itching
4. DNormal skin colour with diarrhoea and fever

A patient with haematemesis becomes drowsy and starts to vomit blood again. What is the immediate priority?

1. AComplete the admission paperwork and medication history
2. BTurn the patient onto their side to protect the airway
3. CSend a stool sample for faecal occult blood testing
4. DGive a large glass of iced water to slow the bleeding