Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

A patient is in skeletal traction. Which finding needs the nurse to act?

1. AThe weights are hanging freely
2. BThe ropes are in the pulleys
3. CThe weights are resting on the floor
4. DThe patient’s body is in line with the traction

After a vaginal birth, the uterus is firm and central, but bright red blood keeps trickling steadily. What should the nurse suspect?

1. AUterine atony that needs more massage
2. BA tear in the birth canal or cervix
3. CA full bladder pushing the uterus aside
4. DNormal lochia for the first hour

A patient with a severe latex allergy is booked for surgery. Which measure is commonly used?

1. AUse latex-free supplies and schedule the patient as the first case of the day
2. BGive the patient antihistamines before surgery and then use the normal supplies
3. CWrap latex items in plastic before use
4. DUse latex gloves only for short procedures

A patient on chemotherapy develops shingles over several areas on both sides of the body. Which precautions are needed?

1. AAirborne and contact precautions until all lesions are crusted
2. BStandard precautions only, with the lesions covered
3. CDroplet precautions until the pain settles
4. DContact precautions only, with gloves for dressing changes

A patient taking empagliflozin (an SGLT2 inhibitor) has glucose in the urine but a normal blood glucose. What is the best interpretation?

1. AA sign of kidney failure
2. BA urinary tract infection
3. CUncontrolled diabetes needing insulin
4. DAn expected effect of the drug

Palung vankomisin seorang pesakit ialah 28 mcg/mL; sasaran yang ditetapkan pemreskripsi ialah 15–20 mcg/mL. Dos seterusnya perlu diberi sekarang. Apakah tindakan terbaik?

1. ATahan dos, maklumkan pemreskripsi dan periksa fungsi buah pinggang
2. BBeri dos berganda untuk menamatkan kursus dengan lebih cepat
3. CBeri dos seperti dijadualkan dan semak semula paras palung dalam seminggu
4. DBeri dos dalam tempoh yang lebih singkat untuk mengurangkan pendedahan

Sawan pesakit telah berlangsung lebih daripada lima minit. Apakah maksudnya?

1. AIa normal dan tidak memerlukan rawatan
2. BIa patut dirawat sebagai status epileptikus dan ubat kecemasan diberi
3. CKekang anggota badan untuk menghentikan pergerakan
4. DLetakkan sesuatu dalam mulut untuk mencegah lidah tergigit

An older patient found on the floor after lying there for many hours has dark brown urine and a very high creatine kinase. What is the main risk?

1. AAcute kidney injury from rhabdomyolysis
2. BHypoglycaemia
3. CA stroke
4. DA urinary tract infection from lying in urine

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

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

A patient on an unfractionated heparin infusion has a nosebleed that will not stop, and the aPTT is far above the target range. What is the most appropriate action?

1. AGive vitamin K and continue the infusion at a slightly lower rate
2. BContinue the infusion at the same rate and pack the nose firmly
3. CStop the infusion, inform the prescriber and anticipate protamine
4. DIncrease the infusion, as the aPTT will settle

A patient with untreated hyperthyroidism is losing weight. Which diet is most appropriate until the condition is controlled?

1. AA strict low-protein diet
2. BA low-calorie diet to protect the heart
3. CA high-calorie diet with enough protein
4. DA diet very high in caffeine for energy

A patient's corrected calcium is 1.7 mmol/L (about 6.8 mg/dL). Which ECG change is most typical?

1. AA prolonged QT interval
2. BTall, peaked T waves
3. CA shortened QT interval
4. DST elevation in all leads

After a percutaneous liver biopsy, how is the patient usually positioned at first?

1. ASitting upright, with the legs over the edge of the bed
2. BProne, with the head lower than the feet
3. COn the left side, to drain the liver
4. DOn the right side, to press on the puncture site

Seorang berumur 74 tahun dengan penyakit buah pinggang kronik mengalami kesakitan teruk selepas pembedahan. Isu opioid manakah yang paling penting?

1. AOpioid tidak boleh sekali-kali digunakan pada warga emas, apa pun kesakitannya
2. BMorfin ialah opioid paling selamat dalam kegagalan buah pinggang, jadi dos boleh dinaikkan dengan bebas
3. CMetabolit morfin terkumpul, jadi dos yang lebih rendah atau opioid lain mungkin diperlukan
4. DFungsi buah pinggang tidak memberi kesan terhadap cara opioid dikendalikan