Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

A patient coughs hard after abdominal surgery, and loops of bowel appear through the opened wound. What does the nurse do first?

1. AHelp the patient walk to the toilet to relieve abdominal pressure
2. BPush the bowel gently back into the abdomen with a gloved hand
3. CLeave the wound uncovered so the surgeon can see it on arrival
4. DCover the wound with sterile dressings moistened with saline

During surgery under general anesthesia, a patient develops rising end-tidal carbon dioxide, muscle rigidity and a rapidly increasing temperature. Which drug should the nurse anticipate?

1. ANaloxone
2. BDantrolene
3. CFlumazenil
4. DAtropine

Before helping a patient from bed into a wheelchair, what should the nurse do with the wheelchair?

1. ALock the brakes and place it close to the bed on the patient’s stronger side
2. BPlace it on the patient’s weaker side so that side is supported
3. CPlace it at the foot of the bed, facing away
4. DLeave the brakes off so the chair can move along with the patient during the pivot

A patient has a rash, and both smallpox and chickenpox are considered. Which finding suggests smallpox?

1. ASmall crops of new lesions appearing over several days in a row
2. BLesions all at the same stage, most dense on the face and limbs
3. CLesions at different stages, most dense on the trunk
4. DA rash that is very itchy and starts on the trunk

A patient has a calcium of 11.8 mg/dL (2.95 mmol/L) from bone metastases. Which nursing measure is appropriate?

1. AEncourage fluids and mobility as tolerated
2. BOffer extra milk and cheese at each meal
3. CEncourage bed rest and limit oral fluids
4. DGive calcium carbonate antacids for nausea

Seorang pesakit trombosis vena dalam yang baharu menerima infusi heparin, dan warfarin baru dimulakan. Mengapakah heparin diteruskan selama beberapa hari?

1. AWarfarin hanya berfungsi apabila heparin diberi pada masa yang sama
2. BHeparin mencegah kesan sampingan warfarin
3. CHeparin meningkatkan penyerapan warfarin daripada usus
4. DWarfarin mengambil masa beberapa hari untuk mencapai kesan antikoagulan sepenuhnya

Which type of painkiller should a patient with liver cirrhosis usually avoid?

1. AParacetamol (acetaminophen), given in a carefully reduced and monitored dose
2. BHot packs applied to a painful joint
3. CLocal anaesthetic creams
4. DNon-steroidal anti-inflammatory drugs such as ibuprofen

A patient on metformin with reduced kidney function is due a CT scan with IV contrast. Why might metformin be withheld?

1. AMetformin causes severe bleeding during scans
2. BThere is a risk of lactic acidosis if kidney function worsens
3. CMetformin makes the images blurry
4. DMetformin reacts with the contrast to cause severe hyperglycaemia

Seorang pesakit yang mengambil warfarin mula makan salad bayam dan kale dalam jumlah besar setiap hari. Apakah kebimbangan utama?

1. ASayur-sayuran hijau merosakkan hati semasa mengambil warfarin
2. BVitamin K tambahan mungkin meningkatkan INR
3. CTiada interaksi antara makanan dengan warfarin
4. DVitamin K tambahan mungkin merendahkan INR

A patient is going home after a spontaneous pneumothorax treated with a chest drain. Which advice is correct?

1. AStop smoking and do not fly until a doctor confirms full resolution
2. BTake up scuba diving to strengthen the lungs
3. CExpect it never to happen again, so no follow-up is needed
4. DFly home as soon as possible so they can recover in comfort there

A patient with severe vomiting and diarrhoea takes ramipril, furosemide and metformin. Which advice is correct?

1. ADouble the furosemide to prevent fluid retention
2. BAdd ibuprofen to treat the abdominal cramps
3. CPause these medicines until eating and drinking again
4. DKeep taking everything as normal and drink less

A patient with renal colic has normal kidney function and no other contraindications. Which drug is usually the first choice for pain?

1. AAn oral antihistamine such as cetirizine
2. BAn NSAID such as diclofenac
3. CA benzodiazepine such as diazepam
4. DOral paracetamol (acetaminophen) alone

Apakah perbezaan klinikal utama antara sekatan usus kecil dan usus besar?

1. ATiada perbezaan klinikal; hanya imbasan CT yang dapat membezakannya
2. BUsus kecil: kembung ketara sahaja; usus besar: tiada sakit, tiada muntah dan tiada kembung langsung
3. CUsus kecil: muntah awal, kurang kembung; usus besar: muntah lewat, kembung ketara
4. DUsus kecil: tiada muntah langsung; usus besar: muntah awal yang banyak tanpa kembung

An incontinent patient has diffuse, shiny, red and broken skin in the natal cleft and buttocks with irregular edges, not over a bony prominence. What is most likely?

1. AAn arterial ulcer caused by poor circulation
2. BA full-thickness burn
3. CIncontinence-associated dermatitis
4. DA category 4 pressure ulcer over the sacrum