Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

Pesakit manakah yang boleh dilihat terakhir dengan selamat oleh jururawat?

1. APesakit dua jam selepas pembedahan dengan kadar denyutan jantung meningkat daripada 88 kepada 118/min
2. BPesakit dengan krepitasi baharu dan kahak berbuih merah jambu
3. CPesakit COPD dengan oksigen 1 L/min, SpO₂ 90% (sasaran 88–92%), bercakap dalam ayat penuh
4. DPesakit dengan sakit kepala teruk yang mendadak

A patient with a severe asthma attack had a PaCO₂ of 32 mmHg (4.3 kPa) on arrival. An hour later it is 46 mmHg (6.1 kPa), and the patient seems tired. What does this suggest?

1. AA laboratory error that should be ignored
2. BThe patient is hyperventilating even more than before and needs calming
3. CRespiratory muscle fatigue with possible impending respiratory failure
4. DThe asthma is improving, because the PaCO₂ is now near normal

Why is blood glucose control important around the time of surgery?

1. AHigh glucose makes anesthetic drugs work for much longer and delays waking up
2. BGlucose levels only affect patients who have type 1 diabetes
3. CHigh glucose impairs white cell function and raises the risk of surgical site infection
4. DLow glucose is needed around surgery so that the wound edges close more quickly

Shortly after a patient falls, the team holds a brief “post-fall huddle”. What is its main purpose?

1. ATo agree on what the team will tell the patient’s lawyer and the family
2. BTo decide which staff member was to blame for the fall
3. CTo find out quickly why the fall happened and change the care plan to prevent another
4. DTo complete the patient’s discharge paperwork

A patient's eGFR has fallen to 24 mL/min/1.73 m². Which prescribed drug should the nurse question before giving it?

1. AAcetaminophen (paracetamol)
2. BLevothyroxine
3. CInsulin glargine
4. DMetformin

A patient on stable digoxin starts amiodarone. A week later, the patient has nausea and visual changes, and the digoxin level is above the range. What is the most likely explanation?

1. AAmiodarone has raised the digoxin level
2. BThe patient has started a viral illness
3. CDigoxin has raised the amiodarone level
4. DAmiodarone has lowered potassium only

During a red cell transfusion, when are serious acute reactions most likely to start?

1. AAfter the third unit only
2. BAbout 24 hours later
3. COnly after the unit has finished
4. DIn the first 15 minutes

A severely hypothermic patient is in cardiac arrest. Why is resuscitation usually continued until they are rewarmed?

1. AHypothermia always causes brain death quickly
2. BAdrenaline works better in cold patients
3. CCold patients cannot be defibrillated at all, so CPR is the only possible treatment
4. DThe cold protects the brain, so recovery may be possible after long resuscitation

Seorang pesakit telah mengalami fibrilasi atrium lebih daripada 48 jam dan disenaraikan untuk kardioversi elektif. Mengapakah antikoagulasi diperlukan terlebih dahulu?

1. AAntikoagulan menukar AF kembali kepada irama sinus
2. BAntikoagulan mengurangkan tenaga elektrik yang diperlukan untuk kejutan
3. CAntikoagulan menjadikan kejutan kurang menyakitkan
4. DBekuan atrium mungkin tercabut apabila irama sinus kembali

A patient with a stab wound to the chest has a hole that sucks air with each breath. What is the immediate management?

1. ASeal it completely with tape on all four sides and leave it alone
2. BLeave it open and give a nebuliser
3. CCover it with a vented chest seal or a dressing taped on three sides
4. DPack the wound tightly with gauze pushed deep into the chest

Why can a patient with an insulin pump develop DKA within hours if the pump stops working?

1. AThe body becomes allergic to insulin when the pump stops
2. BThe pump gives only rapid-acting insulin, so there is no long-acting reserve
3. CThe battery in the pump releases chemicals into the blood
4. DThe pump gives long-acting insulin, which builds up and stops working all at once

A patient with an external ventricular drain sat up in bed without help. The drain stayed at its old height, and the drainage bag filled quickly. The patient now has a headache. What is the concern?

1. AAn infected drain, so the dressing should be removed
2. BNo concern, because more drainage always lowers the ICP safely
3. COverdrainage of CSF, so act per protocol and inform the team
4. DUnderdrainage, so the drain should be lowered further

Why do patients usually have a dental review before radiotherapy to the head and neck?

1. AThe dentist gives the radiotherapy
2. BRadiotherapy can only be given once all the teeth have been removed
3. CTeeth block the radiation beam completely
4. DIt causes dry mouth and raises the risk of decay and jaw damage

A few hours after an ERCP, a patient has severe epigastric pain radiating to the back, with vomiting. Which complication is most likely?

1. AHepatitis B infection
2. BPost-ERCP pancreatitis
3. CBiliary colic from a new stone
4. DAcute appendicitis