Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

A nurse teaches a patient with COPD pursed-lip breathing. Which statement shows a need for further teaching?

1. A“I will breathe in through my mouth and out quickly through my nose.”
2. B“I will breathe in slowly through my nose.”
3. C“I will breathe out slowly through pursed lips.”
4. D“I will make my breath out about twice as long as my breath in.”

During an infusion of a thrombolytic drug for stroke, the patient develops a severe headache and starts vomiting. What should the nurse do first?

1. AGive a dose of aspirin for the headache
2. BContinue the infusion, because headache is expected
3. CStop the infusion and inform the provider at once
4. DSlow the infusion and give an antiemetic as prescribed

Mengapakah pen insulin tidak boleh digunakan untuk lebih daripada seorang pesakit, walaupun dengan jarum baharu?

1. ASetiap pen hanya mengandungi satu dos insulin
2. BInsulin dalam pen akan luput lebih cepat apabila dikongsi
3. CDarah boleh mengalir balik ke dalam kartrij dan menyebarkan jangkitan
4. DBerkongsi pen mengubah dos yang disampaikan

A nurse teaches a patient going home with an MRSA wound infection. Which statement shows a need for further teaching?

1. A“I will wash my hands after touching my dressing.”
2. B“I can share towels with my family if I wash them every week.”
3. C“I will put used dressings in a sealed bag before throwing them out.”
4. D“I will keep the wound covered with a clean, dry dressing.”

During a red cell transfusion, when are serious acute reactions most likely, so the nurse stays with the patient?

1. AAfter about 2 hours
2. BAfter the last drop is given
3. CThe next morning
4. DIn the first 15 minutes

Seorang pesakit yang mengambil digoksin mempunyai paras 1.2 ng/mL, kalium 2.8 mEq/L dan denyutan ektopik ventrikel kerap yang baharu. Apakah tafsiran yang terbaik?

1. APesakit memerlukan dos digoksin yang lebih tinggi untuk mengawal irama
2. BDigoksin tidak mungkin puncanya, kerana paras berada dalam julat lazim
3. CKetoksikan mungkin berlaku, kerana kalium rendah meningkatkan kesan digoksin
4. DKalium tidak mempunyai kesan pada irama jantung

Why must levodopa for Parkinson's disease be given at the exact times prescribed in hospital?

1. ADelays can quickly worsen rigidity, immobility and swallowing
2. BThe drug only works if taken at midnight
3. CEarly doses cause severe low blood glucose and sweating attacks
4. DLate doses cause dangerous high potassium

Which sign is often a late finding in hypovolaemic shock in a young, previously fit adult?

1. AA rise in heart rate
2. BA fall in blood pressure
3. CA slightly raised respiratory rate
4. DCool peripheries

After coronary artery bypass surgery through a median sternotomy, which instruction is usually given for the first several weeks?

1. AAvoid walking until the stitches are removed
2. BAvoid heavy lifting and pushing up with the arms
3. CLift the arms above the head often to stretch the chest
4. DSleep only on the stomach to protect the wound

Which task for a stable patient with heart failure can the registered nurse most appropriately delegate to a healthcare assistant (unlicensed assistive personnel)?

1. ATeaching the patient about a low-salt diet
2. BDeciding whether to give the furosemide dose
3. CMeasuring and recording the morning weight
4. DAssessing lung sounds for new crackles

A patient with myasthenia gravis wants to plan a busy day. Which advice fits the disease?

1. ADo the hardest tasks in the evening when muscles are warmed up
2. BAvoid rest periods, because rest makes the weakness worse
3. CExercise to exhaustion so the muscles get stronger quickly
4. DDo demanding tasks in the morning or when the drug works best

A nurse teaches a young adult with newly diagnosed epilepsy. Which statement shows a need for further teaching?

1. A"I will take a shower rather than a bath."
2. B"As long as I take my tablets, I can swim alone."
3. C"I will keep a record of any seizures I have."
4. D"I will tell my friends what to do if I have a seizure."

Which factor can precipitate hepatic encephalopathy in a patient with cirrhosis?

1. AA low-salt diet
2. BRegular gentle walking
3. CA high fluid intake
4. DConstipation

Seorang pesakit sekatan usus kecil mempunyai tiub nasogastrik yang menyalirkan 2 L sehari. Tumpuan kejururawatan manakah yang paling penting?

1. AMengapit tiub untuk jangka masa panjang bagi menyimpan cecair perut
2. BMengeluarkan tiub sebaik sahaja 1 L disalirkan untuk mencegah kehilangan
3. CImbangan cecair yang tepat dengan penggantian IV dan semakan elektrolit
4. DMemberikan cecair oral dengan bebas untuk menggantikan apa yang dikeluarkan oleh tiub