Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

Which patient on an addiction unit should the nurse see first?

1. ALast drink one week ago; asking about support groups
2. BLast drink two days ago; now shaking, sweating, heart rate 124/min and seeing insects
3. CLast drink this morning; asking when lunch will arrive
4. DIn recovery for a year; came to the clinic today for a routine check and a repeat prescription

An 85-year-old resident becomes newly confused and is falling, but has no fever. Which cause should the nurse consider first?

1. ABoredom from not having enough activities
2. BNormal aging that needs no assessment
3. CAn infection, such as a urinary tract infection, presenting atypically
4. DA sudden worsening of long-standing dementia that needs no tests

Which IV fluid can be given with packed red blood cells in the same line?

1. A0.9% sodium chloride
2. B5% dextrose in 0.45% sodium chloride
3. C5% dextrose in water
4. DLactated Ringer’s (Hartmann’s) solution

Seorang pesakit pernah mengalami MRSA pada luka dan kini memerlukan penukaran pembalut. PPE manakah yang sesuai?

1. ATiada PPE, jika tangan dibersihkan selepas itu
2. BSarung tangan steril sahaja, tanpa gaun atau perlindungan lain
3. CGaun dan sarung tangan, serta perlindungan mata dan pelitup muka jika percikan mungkin berlaku
4. DRespirator N95 sahaja, kerana MRSA ialah organisma yang rintang

In the US, when is a pregnant woman without known risk factors usually screened for gestational diabetes?

1. AAt about 38–40 weeks of pregnancy
2. BAt about 24–28 weeks of pregnancy
3. CAt about 6–8 weeks of pregnancy
4. DOnly after the baby is born

Seorang pesakit hiponatremia kronik (natrium 118 mEq/L) sedang dirawat. Mengapakah natrium mesti dinaikkan secara perlahan?

1. APembetulan pantas menyebabkan hipokalemia, yang merupakan satu-satunya risiko
2. BPembetulan perlahan hanya diperlukan untuk mengurangkan kos hospital
3. CPembetulan pantas menyebabkan natrium jatuh semula dengan lebih rendah
4. DIa boleh menyebabkan demielinasi osmotik, kecederaan otak yang serius

A patient is receiving IV fluids for several days. Which monitoring is essential?

1. AMonthly HbA1c
2. BFluid balance, regular weights and urea, creatinine and electrolytes
3. CWeekly temperature and a single blood glucose reading
4. DPeak flow readings

Seorang warga emas menjadi keliru secara mendadak pada waktu malam, dengan perhatian yang turun naik. Apakah punca paling mungkin untuk disiasat dahulu?

1. APenuaan normal
2. BPermulaan mendadak penyakit Alzheimer
3. CDelirium yang disebabkan oleh masalah asas seperti jangkitan atau ubat
4. DKurang minat terhadap persekitaran

A patient with heart failure takes furosemide once a day. When is the best time to take it?

1. AAt bedtime, so the effect lasts through the night
2. BWhenever the ankles look swollen, on those days only
3. CIn the morning, to avoid needing the toilet at night
4. DJust before the evening meal, with a large drink

A patient has new chest pain at rest. The ECG shows ST depression, but serial troponins remain normal. Which diagnosis fits best?

1. ANon-ST-elevation myocardial infarction
2. BStable angina
3. CUnstable angina
4. DST-elevation myocardial infarction

Which signs suggest rejection of a kidney transplant?

1. ALess urine, a rising creatinine and a tender graft
2. BA cough, wheeze and a runny nose with sneezing
3. CMore urine, a falling creatinine and weight loss
4. DA rash on the face after sun exposure

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

A patient takes co-codamol at home (a combination tablet sold under different names in different countries). Why should the nurse check this before giving regular paracetamol (acetaminophen)?

1. ACo-codamol must be stopped a week before any paracetamol
2. BParacetamol and codeine cause a severe allergic reaction when combined
3. CCo-codamol stops paracetamol from working
4. DIt already contains paracetamol, so overdose could occur

A patient with active cancer on chemotherapy develops new swelling and pain in one calf. Why must this be reported promptly?

1. AIt is only a muscle strain from walking
2. BCalf swelling is a normal effect of chemotherapy
3. CCancer and its treatment greatly increase clot risk
4. DThe swelling shows the cancer has gone