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

A patient with severe sepsis starts oozing blood from IV sites and the gums, and bruises appear on the skin. What should the nurse suspect?

1. ADisseminated intravascular coagulation (DIC)
2. BVitamin C deficiency
3. CNormal bruising from blood tests
4. DAn allergic reaction to the adhesive tape

A child has swallowed a button battery. Why is this urgent?

1. AIt always passes through the gut without harm
2. BIt can burn through the lining of the esophagus within hours
3. CThe only risk is poisoning from heavy metals years later
4. DIt is only harmful if several batteries are swallowed

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

1. AA rash that is very itchy and starts on the trunk
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. DSmall crops of new lesions appearing over several days in a row

A patient's levothyroxine dose was changed today. When is the TSH usually rechecked?

1. AAfter about 24 hours
2. BAfter about 6–8 weeks
3. CAfter about 1 year
4. DAfter about 3 days

A patient has a sodium of 150 mEq/L, a glucose of 180 mg/dL and a BUN of 28 mg/dL. Using the formula 2 × Na + glucose/18 + BUN/2.8, what is the calculated serum osmolality?

1. AAbout 320 mOsm/kg, which is high
2. BAbout 285 mOsm/kg, which is normal
3. CAbout 358 mOsm/kg, which is high
4. DAbout 300 mOsm/kg, which is normal

After a needlestick injury from a patient known to have HIV, why must the nurse report it immediately?

1. AThe patient will need antibiotics
2. BThe needle must be sent for culture
3. CThe nurse must be tested for HIV the same day to confirm infection
4. DPost-exposure prophylaxis works best when started as soon as possible

Pesakit yang hampir meninggal dunia mempunyai pernafasan berbunyi dan bergelugut akibat rembesan di kerongkong dan tidak sedarkan diri. Pendekatan manakah yang sesuai?

1. ATukar posisi, pertimbangkan ubat antirembesan yang dipreskripsikan dan sokong keluarga
2. BBeritahu keluarga bahawa pesakit tercekik dan memerlukan ventilasi
3. CMulakan cecair intravena pantas untuk mencairkan dan membersihkan rembesan
4. DMulakan sedutan orofaring dalam setiap 10 minit sepanjang malam

A patient taking isosorbide mononitrate asks about sildenafil for erectile dysfunction. What is the main danger?

1. AA very high potassium level
2. BSevere hypertension
3. CSevere hypotension
4. DBleeding from the gums

A patient with a COPD exacerbation has been on NIV for two hours. They are now more drowsy, and the pH has fallen further despite a good mask fit. What should the nurse do?

1. AGive a sedative to help the patient tolerate the mask
2. BContinue NIV unchanged and repeat the blood gas tomorrow morning
3. CRemove the mask and give nebulised bronchodilators only from now on
4. DEscalate urgently for review of intubation or a ceiling of care

Which picture fits anterior cord syndrome?

1. AArms much weaker than legs after a neck injury
2. BLoss of movement and pain sense, with position sense kept
3. CNormal movement but complete loss of position sense
4. DWeakness on one side and loss of pain sensation on the other side

Which task for a patient with a urinary catheter can the nurse delegate to a healthcare assistant (nursing assistant)?

1. AAssessing a patient whose irrigation is not draining
2. BEmptying the drainage bag and recording the volume
3. CTeaching self-catheterisation for the first time
4. DDeciding whether the catheter can be removed

Apakah peranan sekatan natrium dan spironolakton dalam sirosis?

1. AUntuk merendahkan ammonia darah dan merawat ensefalopati
2. BUntuk mengurangkan pengekalan natrium dan air serta mengawal asites
3. CUntuk meningkatkan kehilangan kalium dan mencegah hiperkalemia
4. DUntuk menaikkan tekanan darah dan memperbaik aliran darah buah pinggang

A patient with haematemesis becomes drowsy and starts to vomit blood again. What is the immediate priority?

1. AGive a large glass of iced water to slow the bleeding
2. BTurn the patient onto their side to protect the airway
3. CSend a stool sample for faecal occult blood testing
4. DComplete the admission paperwork and medication history