Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

An arterial blood gas shows pH 7.28, PaCO₂ 40 mmHg (5.3 kPa) and HCO₃⁻ 16 mEq/L (mmol/L). How should the nurse interpret it?

1. AMetabolic acidosis
2. BMetabolic alkalosis
3. CRespiratory alkalosis
4. DRespiratory acidosis

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

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

A family member tells the nurse, “My father is not himself. Something is wrong.” The hospital has a family-activated rapid response system. What is correct?

1. AThe family should call emergency services from outside the hospital
2. BThe family must wait for the next scheduled ward round to raise the concern with a doctor
3. CThe family can call the rapid response team if they are worried and staff have not responded
4. DOnly doctors may call the rapid response team

A toddler has bruises of different ages and a burn, and the parent’s explanation does not fit the injuries. What should the nurse do?

1. ADocument only and say nothing to anyone
2. BConfront the parent and ask them to admit to abuse
3. CReport the concern following child-protection (safeguarding) procedures
4. DWait until there is clear proof of abuse before reporting anything at all

Seorang pesakit dengan aritmia ventrikel menunjukkan corak berpusing (torsades de pointes) pada monitor. Elektrolit manakah yang lazim diberikan secara IV sebagai rawatan?

1. AMagnesium sulfat
2. BKalium fosfat
3. CNatrium bikarbonat
4. DKalsium karbonat

Selepas kemoterapi untuk limfoma yang membesar pantas, corak keputusan manakah yang mencadangkan sindrom lisis tumor?

1. AElektrolit normal dengan hemoglobin tinggi
2. BKalium tinggi, fosfat tinggi, asid urik tinggi dan kalsium rendah
3. CKalium rendah, fosfat rendah, asid urik rendah dan kalsium meningkat
4. DNatrium tinggi dan glukosa rendah sahaja

A patient with COPD and known carbon dioxide retention needs a nebulised bronchodilator. How should it usually be given?

1. AOnly with the patient lying flat
2. BWithout monitoring oxygen saturation
3. CDriven by compressed air, with oxygen given separately if needed
4. DDriven by high-flow oxygen at 15 L/min for as long as possible

After a head injury, a patient has clear fluid leaking from the nose. What does this most likely suggest?

1. AAllergic rhinitis triggered by the hospital environment
2. BA normal and harmless response to head trauma
3. CAcute sinusitis
4. DA base-of-skull fracture with a cerebrospinal fluid leak

Which energy-conservation advice is most useful for a patient with severe COPD?

1. ASit down for tasks such as washing and dressing, and pace activities
2. BHold the breath while lifting heavy objects
3. CDo all the household tasks quickly in the morning to get them done
4. DAvoid any activity at all, staying in a chair to save their energy

A nurse has four cardiac patients. Which one should be seen first?

1. AA patient with heart failure whose weight is 0.3 kg up on yesterday's morning weight
2. BA patient after a radial angiogram asking when they can eat
3. CA patient with AF and a heart rate of 86/min who is due an apixaban dose this morning
4. DA patient with angina whose chest pain has not eased with rest and who is sweating

The day after a thyroidectomy, a patient reports tingling around the mouth and in the fingers. Why might this happen?

1. AThe anaesthetic has caused an allergic reaction
2. BThe parathyroid glands may have been damaged, lowering calcium
3. CThe patient is breathing too slowly after the operation
4. DThe thyroid hormone level has risen too high after surgery

A patient with an insulin pump is admitted with nausea, a glucose of 19 mmol/L (342 mg/dL) and blood ketones of 3.1 mmol/L. What is the priority?

1. ASuspect failed insulin delivery and give insulin by another route
2. BGive an antiemetic only, because nausea is causing the high glucose
3. CDisconnect the pump and give no insulin until the ketones clear
4. DIncrease the pump rate and recheck the ketones in 12 hours

Pernyataan manakah tentang analgesia multimodal yang betul?

1. AIa kaedah yang digunakan hanya untuk kesakitan kronik jangka panjang
2. BHanya satu analgesik patut diberikan pada satu masa
3. CUbat dengan tindakan berbeza digabungkan untuk mengurangkan keperluan opioid
4. DBeberapa opioid berbeza digabungkan untuk kesan keseluruhan yang lebih kuat

Sepuluh hari selepas kemoterapi, seorang pesakit mempunyai suhu 37.6 °C tetapi berasa menggigil dan tidak sihat, dengan nadi 112/min dan TD 95/60 mmHg. Apakah tindakan yang betul?

1. AMenunggu kiraan neutrofil sebelum memutuskan sebarang rawatan
2. BMerawat sebagai kemungkinan sepsis neutropenik: antibiotik IV dalam masa sejam
3. CMemberikan parasetamol dan menyemak semula suhu dalam empat jam
4. DMenenangkan pesakit, kerana suhu masih di bawah 38 °C