Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

Semasa infusi antibiotik IV, seorang pesakit mengalami ruam gatal, berdehit dan suara serak. Apakah yang dilakukan oleh jururawat dahulu?

1. AHentikan infusi
2. BBeri difenhidramina oral
3. CPerlahankan infusi kepada separuh kadar
4. DDokumenkan tindak balas dalam carta

Seorang pesakit dengan trakeostomi baharu batuk, bernafas dengan bising dan SpO₂ telah jatuh kepada 86%. Apakah tindakan pertama?

1. ADokumenkan SpO₂ dan semak semula dalam 30 minit
2. BTukar tali trakeostomi
3. CSedut trakeostomi
4. DBeri bronkodilator nebulisasi

A patient with a severe latex allergy is booked for surgery. Which measure is commonly used?

1. AWrap latex items in plastic before use
2. BUse latex-free supplies and schedule the patient as the first case of the day
3. CUse latex gloves only for short procedures
4. DGive the patient antihistamines before surgery and then use the normal supplies

A nurse has just started a unit of red blood cells when a colleague asks for urgent help with another patient. What is the best action?

1. APause the transfusion until the nurse is free again
2. BLeave to help the other patient, and check the transfusion again in about an hour
3. CSpeed up the transfusion so it finishes sooner
4. DStay with the transfusing patient for the first 15 minutes and ask another nurse to help

How does normal pregnancy usually affect serum creatinine?

1. AIt stays exactly the same
2. BIt rises, because GFR falls
3. CIt rises with every week
4. DIt falls, because GFR rises

A patient has taken metformin for 8 years and now has numbness in the feet, a hemoglobin of 10.2 g/dL (102 g/L) and an MCV of 108 fL. Which deficiency is most likely?

1. AVitamin K deficiency
2. BVitamin D (calciferol) deficiency
3. CVitamin B₁₂ deficiency
4. DIron deficiency from gut loss

A rising serum creatinine most often indicates:

1. AReduced kidney function
2. BIncreased muscle strength
3. CImproved liver function
4. DDehydration of the skin only

Seorang pesakit mengalami loya dan muntah selama tiga hari dan mengambil furosemid. Masalah elektrolit manakah yang paling berkemungkinan?

1. AHiperkalemia
2. BHipernatremia sahaja
3. CHiperkalsemia
4. DHipokalemia

A patient stops ramipril because of a troublesome dry cough. Which drug class is a common alternative?

1. AA loop diuretic such as furosemide
2. BA non-selective beta-blocker such as propranolol
3. CA nitrate such as isosorbide mononitrate
4. DAn angiotensin II receptor blocker such as losartan

A patient declines enoxaparin for VTE prevention because it is made from pork, which conflicts with their beliefs. What is the best response?

1. ATell the patient that refusal means they cannot have surgery
2. BDocument the refusal in the notes and take no further action at all
3. CGive the injection anyway without explaining what the medicine is made from
4. DRespect the decision, inform the prescriber and discuss non-animal options

Why does a patient with untreated hypothyroidism need extra care when given opioids or sedatives?

1. AThese drugs make the thyroid gland overactive
2. BThey clear the drugs too fast, so higher doses are needed
3. CThere is no difference compared with other patients
4. DThey break the drugs down slowly and are more sensitive to them

A patient has had a high sodium of 160 mmol/L for several days. Why must it be corrected slowly?

1. ARapid correction raises the blood glucose
2. BRapid correction can cause brain swelling
3. CThe sodium will rise again if corrected quickly
4. DRapid correction causes kidney stones

Which treatment often relieves pain from a bone metastasis?

1. AA diet low in calcium and vitamin D
2. BPalliative radiotherapy to the area
3. CComplete bed rest for a month
4. DIron supplements by mouth for several months

Seorang pesakit kanser paru-paru mengalami bengkak muka, vena leher mengembung dan sesak nafas yang bertambah teruk apabila berbaring. Kecemasan manakah yang berkemungkinan?

1. AEmbolisme pulmonari masif
2. BMampatan saraf tunjang
3. CSekatan vena kava superior
4. DHiperkalsemia akibat keganasan