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 make my breath out about twice as long as my breath in.”
4. D“I will breathe out slowly through pursed lips.”

An RN sees an LPN/LVN crushing an extended-release metoprolol tablet to mix with applesauce. What should the RN do?

1. AStop the LPN/LVN and contact the prescriber or pharmacist about another form
2. BLet the LPN/LVN continue, since crushing makes the tablet easier to swallow
3. CTell the LPN/LVN to give half of the crushed tablet now and the other half at lunchtime
4. DReport the LPN/LVN at the end of the month without saying anything now

Pustaka ubat pam infusi memberi amaran bahawa dos yang diprogramkan melebihi had selamat. Apakah yang patut dilakukan oleh jururawat?

1. AMeneruskan infusi dan menyemak semula pam pada akhir syif
2. BMematikan pustaka ubat untuk infusi ini
3. CMengatasi isyarat amaran, kerana amaran pam sering salah
4. DMenyemak semula arahan, pengiraan dan tetapan pam terlebih dahulu

Seorang pesakit menerima ubat berisiko tinggi melalui infusi berterusan. Semasa serah terima, amalan manakah yang paling selamat?

1. AKedua-dua jururawat menyemak pam dan beg berbanding preskripsi
2. BHanya kadar disemak, bukan ubat atau kepekatan
3. CJururawat yang bertugas sebelumnya berkata “pam itu baik-baik sahaja” di meja
4. DJururawat yang menggantikan menyemaknya pada akhir syif

A patient with hyperkalemia received IV regular insulin with dextrose. Which result must the nurse monitor closely over the next hours?

1. ASerum sodium, because it rises quickly
2. BSerum calcium, because it falls sharply
3. CHemoglobin, because insulin causes red cell loss
4. DBlood glucose, because hypoglycemia can occur

A patient with cirrhosis and ascites has fever and abdominal tenderness. The ascitic fluid neutrophil count is 400 cells/mm³. What does this indicate?

1. ASpontaneous bacterial peritonitis
2. BMalignant ascites from cancer
3. CNormal ascitic fluid in cirrhosis
4. DBleeding into the abdominal cavity

Dalam tempoh masa manakah trombolisis IV lazimnya diberi untuk strok iskemia akut?

1. APada bila-bila masa dalam seminggu
2. BHanya selepas 24 jam
3. CDalam masa 4.5 jam selepas bermula gejala
4. DDalam masa 48 jam selepas bermulanya gejala

Soon after starting chemotherapy for a high-grade lymphoma, a patient has rising potassium, phosphate and uric acid with falling urine output. What is the most likely cause?

1. ATumour lysis syndrome
2. BSyndrome of inappropriate ADH secretion
3. CRefeeding syndrome
4. DAdrenal insufficiency

After an acute coronary syndrome, a patient with a normal cholesterol level is prescribed a high-intensity statin. Why?

1. AStatins reduce further events whatever the starting cholesterol
2. BStatins work as painkillers for chest pain
3. CStatins are given after an ACS mainly to lower the blood pressure
4. DStatins are needed only if the cholesterol level is very high

A patient with a tracheostomy suddenly becomes distressed, and a suction catheter will not pass down the tube. What should the nurse do first?

1. AGive a nebulised bronchodilator
2. BInflate the cuff with more air
3. CIncrease the oxygen and wait
4. DRemove the inner cannula

Why is an ACE inhibitor often given to a patient with diabetes and albumin in the urine?

1. AIt raises potassium to protect the heart
2. BIt protects the kidneys and reduces albumin loss
3. CIt stops the kidneys from passing so much urine at night
4. DIt lowers the blood glucose to normal

Which task for a patient with a urinary catheter can the nurse delegate to a healthcare assistant (nursing assistant)?

1. ATeaching self-catheterisation for the first time
2. BAssessing a patient whose irrigation is not draining
3. CEmptying the drainage bag and recording the volume
4. DDeciding whether the catheter can be removed

Why is IV albumin often given after a large-volume paracentesis?

1. ATo treat infection in the ascitic fluid
2. BTo replace the clotting factors and platelets lost in the drained fluid
3. CTo prevent low blood pressure and kidney injury from fluid shifts
4. DTo raise the blood glucose after the procedure

A nurse finds a dislodged sealed radiation source in the bed of a patient receiving brachytherapy. What should the nurse do?

1. APick it up with gloved hands and put it in the nearest sharps bin quickly
2. BUse long-handled forceps to put it in the lead container; report it
3. CThrow it in the clinical waste bag
4. DLeave it in the bed until the end of the shift