Ưu tiên và ủy quyền kiểu NCLEX: gói ôn nước rút

A nurse teaches a patient to use an incentive spirometer. Which statement shows a need for further teaching?

1. A“I will use it several times every hour while awake.”
2. B“I will breathe in slowly and deeply through the mouthpiece.”
3. C“I will blow into it as hard and fast as I can.”
4. D“I will try to hold my breath for a few seconds at the top.”

A chemical cleaning fluid splashes into a patient’s eye. What should the nurse do first?

1. AFlush the eye with plenty of water or saline straight away
2. BGive antibiotic eye drops first
3. CRub the eye gently with a clean tissue to remove the chemical
4. DCover the eye with a dry patch and wait for the provider

Which part of a sterile surgical gown is considered sterile once it is on?

1. AThe front from chest to the level of the sterile field, and the sleeves
2. BThe front from the neck down to the knees
3. CThe whole gown, including the back, the collar and the area below the waist
4. DOnly the back of the gown, which nobody touches

A nurse has just started a unit of red blood cells when a colleague asks for urgent help with another patient. What is the best action?

1. ALeave to help the other patient, and check the transfusion again in about an hour
2. BPause the transfusion until the nurse is free again
3. CSpeed up the transfusion so it finishes sooner
4. DStay with the transfusing patient for the first 15 minutes and ask another nurse to help

A patient on hemodialysis has an arteriovenous (AV) fistula in the left arm. Where should the nurse draw routine blood samples?

1. AFrom the left wrist
2. BFrom the left hand
3. CFrom the right arm
4. DFrom the fistula

Which cerebrospinal fluid (CSF) pattern most strongly suggests bacterial meningitis?

1. AClear fluid, high glucose, low protein, many red cells
2. BClear fluid, normal glucose, normal protein, no white cells
3. CCloudy fluid, low glucose, high protein, many neutrophils
4. DClear fluid, normal glucose, mildly raised protein, lymphocytes

For a patient in skin traction on the leg, which is correct?

1. AThe rope is tied to the bed frame to keep it still
2. BThe weights hang freely and do not rest on the bed or floor
3. CThe weights rest on the floor overnight
4. DThe weights are removed whenever the patient feels uncomfortable

A severely hypothermic patient is in cardiac arrest. Why is resuscitation usually continued until they are rewarmed?

1. AThe cold protects the brain, so recovery may be possible after long resuscitation
2. BHypothermia always causes brain death quickly
3. CAdrenaline works better in cold patients
4. DCold patients cannot be defibrillated at all, so CPR is the only possible treatment

A patient with a mechanical heart valve asks to switch from warfarin to apixaban. What is the correct response?

1. AAspirin alone can replace warfarin once the valve has healed
2. BAny anticoagulant works equally well once the valve is in place
3. CMechanical valves do not need anticoagulation after the first month
4. DDirect oral anticoagulants are not used for mechanical valves

Bốn giờ sau can thiệp mạch vành qua da qua động mạch đùi, băng vùng bẹn thấm đẫm máu và một khối sưng cứng đang to lên. Hành động tức thì là gì?

1. AẤn mạnh ngay phía trên vị trí chọc và gọi hỗ trợ
2. BGiúp bệnh nhân ngồi dậy và đi vệ sinh để tiểu
3. CTháo băng và để vị trí hở ra không khí
4. DTăng tốc độ truyền heparin để không hình thành cục máu ở đó

How does the nurse test the facial nerve (VII)?

1. AAsk them to raise the eyebrows, shut the eyes tightly and smile
2. BTouch the forehead, cheek and chin with cotton wool
3. CAsk the patient to stick out the tongue and move it from side to side
4. DShine a light in each eye and check the pupil response

Sau cắt toàn bộ tuyến giáp, bệnh nhân lo lắng, thở rít và có khối sưng căng ở cổ. Điều dưỡng nên làm gì trước tiên?

1. AGọi hỗ trợ cấp cứu: khối máu tụ có thể chèn ép đường thở
2. BCho thuốc giảm đau và đánh giá lại khối sưng sau một giờ
3. CChườm đá lên cổ và cho bệnh nhân nằm phẳng
4. DBảo bệnh nhân nói càng nhiều càng tốt để kiểm tra giọng

Why are accurate fluid balance charts kept after major surgery?

1. ATo decide which meal the patient will have next
2. BTo record when visitors come and go
3. CTo detect dehydration, fluid overload or kidney problems early
4. DTo check how far the patient has walked and how often they get out of bed

A patient arrives in the anaesthetic room without an identity band. What should the nurse do?

1. AProceed and add a band once in recovery
2. BProceed because the patient can say their name
3. CStop and confirm identity, then apply a band
4. DUse the spare identity band from the front of the patient's notes folder