Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

Straight after birth, what is the first priority for a healthy-looking newborn?

1. AWeigh and measure the baby on the scale
2. BGive the first bath to remove the blood and vernix
3. CGive the vitamin K injection before anything else is done
4. DDry and warm the baby while checking that it is breathing

A patient with MRSA in a wound is on contact precautions. Which instruction to the nursing assistant is correct?

1. AOnly wear gloves when touching the wound itself; skin and bedding are safe
2. BWear a respirator mask in the room, because MRSA in a wound spreads through the air to others
3. CWear a gown and gloves for contact with the patient or the room, and use dedicated equipment
4. DNo special precautions are needed if the wound is covered with a dressing

The laboratory calls with a critical lab result by phone. What should the nurse do?

1. ARemember the value and enter it in the chart at the end of the shift
2. BTell the patient the result first and then call the provider
3. CWrite it down, read it back to confirm and report it to the provider promptly
4. DWait for the printed report to arrive before telling the provider about it

Seorang pesakit dengan demensia teruk bangun dari katil seorang diri pada waktu malam dan telah jatuh dua kali. Rancangan manakah yang paling sesuai?

1. AKatil rendah, penggera katil, rondaan ke tandas, lampu malam dan stoking antiselip
2. BMengikat pesakit pada kerusi sepanjang malam
3. CEmpat palang tepi dinaikkan, dengan pintu ditutup pada waktu malam untuk ketenangan
4. DSedatif setiap malam untuk mengekalkan pesakit di atas katil

A patient takes valproate (valproic acid) for epilepsy. Which tests are monitored regularly?

1. ATroponin and B-type natriuretic peptide
2. BSerum lithium and urine specific gravity
3. CLiver function tests and platelet count
4. DThyroid function and serum calcium

A patient on high-dose dexamethasone has a white cell count of 15 × 10³/µL, mostly mature neutrophils with no bands. They have no fever and no signs of infection. What is the most likely explanation?

1. AA new leukemia that is confirmed by this result alone
2. BA steroid effect that moves neutrophils into the circulating blood
3. CCertain sepsis that needs antibiotics started without delay
4. DA laboratory error, because steroids always lower the white count

Pesakit sirosis hati menjadi keliru dan mengantuk, dengan gegaran mengibas pada tangan. Komplikasi manakah yang mungkin?

1. AKeracunan alkohol sahaja
2. BEnsefalopati hepatik
3. CStrok
4. DHipoglisemia akibat insulin

Which type of drug is commonly used to treat neuropathic pain?

1. ASome anticonvulsants or antidepressants, such as gabapentin
2. BAntihistamines such as cetirizine
3. CProton pump inhibitors such as omeprazole
4. DAntibiotics such as amoxicillin, given as a long course

A patient has episodes of severe headache, sweating and palpitations with very high blood pressure. Which rare cause should be considered?

1. AAsthma
2. BPhaeochromocytoma
3. CAortic stenosis
4. DStable angina

A heavy smoker is having surgery tomorrow and asks whether stopping smoking now is pointless. Which reply is most accurate?

1. AIt is pointless unless they stopped smoking at least a year ago
2. BSmoking before surgery protects the lungs from the anaesthetic gases
3. CStopping now will make the operation more dangerous
4. DStopping even today lowers carbon monoxide levels before surgery

A patient with severe vomiting and diarrhoea takes ramipril, furosemide and metformin. Which advice is correct?

1. APause these medicines until eating and drinking again
2. BKeep taking everything as normal and drink less
3. CDouble the furosemide to prevent fluid retention
4. DAdd ibuprofen to treat the abdominal cramps

Six hours after a catheter is removed, a patient has not passed urine and feels uncomfortable. What should the nurse do?

1. ADo a bladder scan to check for retention
2. BWait until the next morning before checking
3. CTell the patient to drink two litres of water quickly
4. DPut the catheter back without assessing

Which group of findings suggests obstruction of the bile duct?

1. AJaundice, dark urine, pale stools and itching
2. BRed urine, black stools and a high blood glucose
3. CNormal skin colour with diarrhoea and fever
4. DPale urine, dark stools and a flapping tremor

A patient on modified-release morphine for cancer pain has needed four breakthrough doses every day for several days. What should the nurse do?

1. AGive all breakthrough doses at the same time
2. BStop the breakthrough doses to reduce opioid use
3. CTell the patient to put up with the pain between doses
4. DReport it, as the regular background dose may need review