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. AMuntah dan kehilangan cecair
2. BPengajaran tentang kemoterapi
3. CSokongan emosi tentang diagnosis
4. DMenghubungi pendeta hospital

A patient with anorexia nervosa is admitted. Which finding is the priority?

1. ARefuses to eat in front of other people
2. BSays she feels fat although she is very thin
3. CHeart rate 38/min and potassium 2.8 mEq/L
4. DHas fine, downy hair on her arms

A patient has received oral radioactive iodine therapy. Which precaution is usually taken?

1. ALimit time close to the patient and handle body fluids per radiation policy
2. BPlace the patient on droplet precautions with a surgical mask
3. CLet the patient share a bathroom with other patients
4. DEncourage pregnant visitors to sit close to the patient to give emotional support

A nurse has a needlestick from a patient known to have hepatitis C. Which statement about management is correct?

1. ANo follow-up is needed because hepatitis C does not spread by needles
2. BThe hepatitis C vaccine series is started at once, with a booster dose six months later
3. CThere is no preventive drug, so baseline and follow-up testing are done to detect infection early
4. DHepatitis C immune globulin is given within 24 hours, followed by a booster dose

In the third trimester of pregnancy, a woman's alkaline phosphatase (ALP) is about twice the usual adult range, and the other liver tests are normal. What is the best interpretation?

1. AA sign of acute viral hepatitis
2. BA normal rise from placental ALP
3. CA sign of blocked bile ducts
4. DA sign of new bone cancer

A patient with thalassemia major has received regular red cell transfusions for years. The ferritin is now very high. What does this most likely show, and what treatment is used?

1. ALiver failure, treated with a liver transplant at once
2. BIron overload, treated with iron chelation therapy
3. CAcute infection, treated with broad-spectrum antibiotics
4. DIron deficiency, treated with IV iron supplements

A patient without diabetes is started on high-dose prednisolone. Why might capillary blood glucose be monitored?

1. ASteroids always cause hypoglycaemia
2. BSteroids can raise the blood glucose
3. CSteroids make glucose meters inaccurate
4. DSteroids destroy the pancreas

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

A patient takes both digoxin and furosemide. Why does the nurse watch the potassium level closely?

1. AHigh potassium is the main effect of furosemide
2. BLow potassium increases the risk of digoxin toxicity
3. CLow potassium makes digoxin stop working completely
4. DPotassium has no link with either medicine

A patient receiving noradrenaline (norepinephrine) through a peripheral cannula has pale, cold skin around the site. What should the nurse do?

1. AIncrease the rate so the drug enters the vein faster and leaks less
2. BMassage the area firmly to spread the drug out into the surrounding tissue
3. CContinue the infusion, as this is expected
4. DStop it at that site, inform the team and follow the extravasation policy

A patient takes an SGLT2 inhibitor. Which sick-day advice is correct?

1. AStop drinking fluids while taking the drug
2. BPause the drug during illness with vomiting or poor intake
3. CKeep taking it as normal, whatever the illness
4. DDouble the dose during illness to control the glucose

A nurse teaches a patient with Hashimoto's thyroiditis about levothyroxine. Which statement shows a need for further teaching?

1. A"I can stop the tablets once I feel back to normal."
2. B"I will take the tablets at the same time each day."
3. C"I will report palpitations or chest pain."
4. D"I will have regular blood tests to check my dose."

Which nerve is at risk if the arm is poorly padded at the elbow during surgery?

1. ASciatic nerve
2. BUlnar nerve
3. CFacial nerve
4. DFemoral nerve

An older patient on regular opioids has small amounts of liquid stool leaking all day, but has not had a formed bowel movement for 6 days. What is the most likely cause?

1. AAcute infective gastroenteritis
2. BFaecal impaction with overflow
3. CA flare of ulcerative colitis
4. DNormal stool pattern on opioids