Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

A patient has a serum potassium of 6.8 mEq/L. Which action comes first?

1. AGive the patient’s scheduled potassium supplement
2. BEncourage foods high in potassium
3. CPlace the patient on a cardiac monitor
4. DRecheck the level next week

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

1. ATukar tali trakeostomi
2. BBeri bronkodilator nebulisasi
3. CSedut trakeostomi
4. DDokumenkan SpO₂ dan semak semula dalam 30 minit

A visitor with a cold wants to see a patient who has severe neutropenia. What should the nurse advise?

1. AVisit only if the cold started more than a day ago
2. BPostpone the visit until the visitor is well
3. CVisit but avoid touching the patient’s bed
4. DVisit as usual after washing the hands

Over a few hours, the emergency department sees many previously healthy people with the same unusual severe symptoms. What should the nurse do?

1. ATell only the patients’ families about the pattern
2. BTreat each patient and wait to see if more arrive next week
3. CSend the patients home quickly to avoid crowding the emergency department
4. DReport it to infection prevention and public health authorities promptly

A patient receiving chemotherapy has an ANC of 300/µL and a new temperature of 38.3 °C (100.9 °F). What should the nurse do first?

1. AEncourage oral fluids and record the fever in the chart
2. BRemove extra blankets and offer a tepid sponge bath
3. CGive acetaminophen (paracetamol) and recheck the temperature in 4 hours
4. DReport it at once so cultures and antibiotics start quickly

A patient taking an SGLT2 inhibitor has nausea and fast breathing. Glucose 190 mg/dL (10.5 mmol/L), pH 7.15, bicarbonate 10 mEq/L, blood ketones high. What is the most likely diagnosis?

1. AEuglycemic diabetic ketoacidosis
2. BHyperosmolar hyperglycemic state
3. CSimple fasting ketosis only
4. DRespiratory acidosis from COPD

Which examination findings suggest a large pleural effusion on one side?

1. AA hyper-resonant chest with the trachea pulled towards that side
2. BWheeze heard over both lungs
3. CDull percussion and reduced breath sounds over the lung base
4. DNormal breath sounds and normal percussion

During a blood transfusion, an older patient with heart failure becomes breathless with a rising blood pressure, raised JVP and crackles in the lungs. What is the most likely cause?

1. ATransfusion-related acute lung injury with hypotension
2. BTransfusion-associated circulatory overload
3. CA febrile non-haemolytic reaction
4. DAnaphylaxis

Set kesan sampingan manakah yang tipikal bagi diuretik tiazid atau seakan tiazid seperti indapamid?

1. ABatuk kering, gangguan rasa dan bengkak pada bibir
2. BNatrium dan magnesium tinggi, dengan glukosa darah rendah
3. CKalium dan natrium rendah, asid urik meningkat dan glukosa meningkat
4. DKalium dan natrium tinggi, asid urik rendah dan glukosa darah rendah

During a thrombolytic infusion for an MI, the patient develops a sudden severe headache, vomiting and new confusion. What should the nurse do first?

1. AStop the infusion and call for urgent medical help
2. BContinue the infusion, as headache is a common side effect
3. CGive a second dose to finish the treatment
4. DSlow the infusion and give an antiemetic

Which nursing action helps most to prevent and manage delirium in an older inpatient?

1. AKeep the lights on all night so the patient can see clearly
2. BRestrain the patient so that they do not wander off the ward
3. CMove the patient to a different room each day for variety
4. DUse glasses and hearing aids and reorient the patient often

A patient with myasthenia gravis took extra pyridostigmine doses. They now have more weakness, heavy salivation, sweating, diarrhoea, small pupils and a slow pulse. What is most likely?

1. AAn allergic reaction to the drug
2. BA cholinergic crisis from too much medication
3. CA normal response to a higher dose
4. DA myasthenic crisis from too little medication

Pendekatan manakah terhadap pemindahan sel darah merah pada pesakit stabil dengan pendarahan GI yang sesuai dengan bukti semasa?

1. AMemindahkan dua unit secara rutin sebelum setiap endoskopi
2. BTidak pernah memindahkan darah, apa pun hemoglobin atau gejalanya
3. CAmbang restriktif, selalunya sekitar 70 g/L, pada kebanyakan pesakit stabil
4. DMemindahkan darah kepada semua orang untuk mengekalkan hemoglobin melebihi 150 g/L sepanjang masa

Pengurusan manakah yang pada amnya disyorkan untuk eskar hitam yang stabil, kering dan utuh pada tumit pesakit dengan peredaran darah yang lemah?

1. AMembuangnya dengan debridemen tajam di sisi katil hari ini
2. BMembiarkannya utuh, melegakan tekanan pada tumit dan merujuk untuk semakan
3. CMerendamnya dalam air setiap hari untuk melembutkannya
4. DMenutupnya dengan bebat mampatan yang ketat