Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

Seorang pesakit yang baru diberitahu dia menghidap kanser menangis, tetapi juga telah muntah beberapa kali dan tidak dapat menahan cecair. Apakah yang ditangani dahulu oleh jururawat?

1. AMenghubungi pendeta hospital
2. BPengajaran tentang kemoterapi
3. CMuntah dan kehilangan cecair
4. DSokongan emosi tentang diagnosis

Tugasan kepada LPN/LVN manakah yang paling sesuai?

1. APesakit yang memerlukan pengajaran discaj untuk warfarin yang baru dimulakan
2. BPesakit dengan fibrilasi atrium baharu yang baru memulakan infusi diltiazem IV
3. CPesakit yang dipindahkan dari rawatan rapi sejam lalu
4. DPesakit COPD yang stabil yang memerlukan bronkodilator nebulisasi berjadual dan ubat oral

Teknik menanggalkan sarung tangan manakah yang betul?

1. ACuci tangan yang bersarung dan guna semula sarung tangan untuk tugas seterusnya
2. BTanggalkan yang pertama dengan memegang bahagian luarnya, kemudian selitkan jari kosong di bawah kolar sarung tangan kedua
3. CTarik kedua-dua sarung tangan serentak pada hujung jari
4. DTanggalkan sarung tangan kedua dengan mencubit bahagian luarnya menggunakan tangan kosong, kemudian cuci tangan

A patient’s white cell differential shows a raised eosinophil count. Which cause is most consistent with this finding?

1. AA viral infection such as a cold
2. BBone marrow suppression from chemotherapy
3. CAn acute bacterial infection
4. DAn allergic reaction or a parasitic infection

A patient has taken a proton pump inhibitor (such as omeprazole) for many years and now has muscle cramps and tremor. Which electrolyte is most likely to be low?

1. AChloride
2. BMagnesium
3. CSodium
4. DPhosphate

An 82-year-old woman without a catheter has a urine culture growing bacteria, but no fever, urinary symptoms or change in mental state. What is the best interpretation?

1. APyelonephritis, which needs admission and IV fluids today
2. BAsymptomatic bacteriuria, usually not treated with antibiotics
3. CContamination, so the culture must be repeated every week
4. DA urinary tract infection that needs urgent IV antibiotics

Which side effect of regular opioids usually needs preventive treatment from the start?

1. AConstipation
2. BHigh blood pressure
3. CDiarrhoea
4. DExcessive hunger

A patient with several days of vomiting and diarrhoea has low blood pressure, low urine output and a rising creatinine. Which description fits best?

1. AChronic kidney disease, treated with long-term dialysis three times a week
2. BIntrinsic kidney injury from glomerulonephritis, treated with high-dose steroids
3. CPre-renal acute kidney injury from poor perfusion, treated by restoring fluid volume
4. DPost-renal acute kidney injury from obstruction, treated with a catheter

How is orthostatic (postural) hypotension usually assessed?

1. ABP once sitting, then once lying down straight after a large meal
2. BBP only standing, after a brisk walk along the corridor
3. CBP lying after rest, then again after 1 and 3 minutes standing
4. DBP in both arms at the same moment while sitting

Four hours after abdominal surgery, a patient's heart rate has risen from 84 to 122/min and they are restless and pale. BP is still 118/76 mmHg, and the surgical drain is filling with blood. What should the nurse conclude?

1. AThe patient is stable because the blood pressure is normal
2. BThe drain is working well, so no action is needed
3. CEarly haemorrhagic shock is likely, so escalate urgently
4. DThe tachycardia is from pain and needs only analgesia

A patient with type 1 diabetes has gastroenteritis and cannot eat. Which sick-day advice is correct?

1. AStop all insulin until normal eating restarts
2. BAvoid drinking fluids to reduce the vomiting
3. CKeep taking basal insulin and check glucose and ketones more often
4. DCheck glucose once a day only and rest in bed until better

On the first day after a kidney transplant, urine output suddenly falls from 200 mL/h to 10 mL/h. What should the nurse check first?

1. AThe patient's temperature and pulse
2. BThe patient's blood glucose level
3. CThat the catheter is not blocked or kinked
4. DWhether the patient has eaten

For which stoma can colostomy irrigation be considered?

1. AAn established descending or sigmoid colostomy
2. BA new ileostomy in the first week
3. CAny stoma that has liquid or very loose output
4. DAn ileal conduit draining urine

A patient finds daily wound dressing changes very painful. What is the most effective nursing approach?

1. AGive analgesia timed so it works during the dressing change
2. BAvoid analgesia so the patient can report any problems during the change
3. CChange the dressing less often than the plan says
4. DDo the dressing quickly and give analgesia afterwards