Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

An anxious patient is breathing very fast and has tingling fingers. The blood gas shows pH 7.51 and PaCO₂ 29 mmHg (3.9 kPa). What should the nurse do first?

1. AGive IV sodium bicarbonate as soon as it can be found
2. BGive oxygen at the highest flow and leave the room
3. CStay with the patient and coach slow, calm breathing
4. DEncourage the patient to breathe even faster

Which patient with cirrhosis should the nurse see first?

1. AWants to talk about stopping drinking alcohol for good
2. BVomiting bright red blood, heart rate 120/min
3. CLong-standing jaundice and itchy skin, asking for cream
4. DLarge ascites that is unchanged from yesterday

A patient needs to be moved up in bed and cannot help much. Which approach is safest?

1. AAsk the patient to push up with their heels alone
2. BUse a friction-reducing sheet with enough staff, with the bed flat if tolerated
3. CHave one nurse pull the patient up by the arms
4. DRaise the head of the bed fully and lift the patient up by the shoulders

Seorang jururawat perasan bahawa ubat yang salah telah disedut, tetapi menyedarinya sebelum memberikannya. Apakah yang patut dilakukan oleh jururawat?

1. AMelaporkannya hanya jika kesilapan yang sama berlaku lagi di unit
2. BTidak berkata apa-apa, kerana pesakit tidak dicederakan
3. CTetap memberikan ubat itu, memandangkan ia sudah disedut
4. DMembuangnya, menyediakan ubat yang betul dan melaporkan kejadian nyaris terlepas

A patient takes high-dose furosemide. Besides potassium, which electrolyte is most commonly lowered?

1. AMagnesium
2. BUric acid
3. CSodium bicarbonate
4. DPhosphate

A patient on IV gentamicin has a trough level above the target, and the creatinine has risen since yesterday. The next dose is due. What is the best action?

1. AGive the dose with extra oral fluids to protect the kidneys
2. BHold the dose and report the results to the prescriber
3. CGive the dose now and recheck the levels next week
4. DGive half of the dose and document the reason for it

Why is continuous bladder irrigation used after a transurethral resection of the prostate (TURP)?

1. ATo stop blood clots from blocking the catheter
2. BTo measure the patient's kidney function
3. CTo give antibiotics directly into the kidneys
4. DTo stretch the bladder back to its normal size

An adult with capacity refuses a blood transfusion for religious reasons, even though it may save their life. What should the nurse do?

1. ARespect the refusal, check it is informed and document it, and inform the team
2. BSedate the patient so the transfusion can be given
3. CAsk a family member to consent instead
4. DGive the transfusion while the patient is asleep, as it is in their best interests

A patient uses a salbutamol (albuterol) inhaler and a steroid inhaler at the same times each day. Which order is usually taught?

1. ASteroid first, then salbutamol straight afterwards
2. BBoth inhalers puffed together in one breath
3. CSalbutamol first, then the steroid after a short wait
4. DThe order makes no difference to either drug

A patient with crushing chest pain has ST elevation in leads V1–V4. Which coronary artery is most likely blocked?

1. AThe left subclavian artery
2. BThe right coronary artery and its branches
3. CThe left anterior descending artery
4. DThe circumflex artery

Pada pesakit dengan kecederaan saraf tunjang akut di C6, gambaran manakah yang menunjukkan renjatan neurogenik?

1. ATekanan darah tinggi, nadi perlahan dan sakit kepala berdenyut
2. BTekanan darah rendah, nadi laju dan kulit sejuk serta lembap
3. CTekanan darah rendah, nadi perlahan dan kulit hangat serta kering
4. DTekanan darah normal, nadi laju dan demam tinggi

A patient with CKD has a potassium of 6.5 mmol/L. Which medicine combination is the most likely contributor?

1. AAmlodipine, simvastatin and aspirin
2. BParacetamol (acetaminophen), omeprazole and senna
3. CRamipril, spironolactone and trimethoprim
4. DFurosemide, salbutamol and insulin

Which is a usual benefit of laparoscopic over open abdominal surgery?

1. ANo need for a general anaesthetic ever
2. BNo risk of any complications at all
3. CLarger wounds that heal faster
4. DLess pain and a shorter hospital stay

Seorang pesakit kanser payudara menjadi keliru, dahaga dan sembelit, dengan poliuria. Kecemasan onkologi manakah yang patut dipertimbangkan?

1. ASindrom lisis tumor
2. BSekatan vena kava superior
3. CHiperkalsemia akibat keganasan
4. DHipoglisemia