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

Which telephone call should a clinic nurse return first?

1. AAn adult who wants to move a routine blood test appointment
2. BA parent of a 6-week-old with a temperature of 38,3 °C
3. CAn adult asking for a repeat prescription for a statin
4. DA parent of a 5-year-old with a runny nose for two days

An RN sees an LPN/LVN crushing an extended-release metoprolol tablet to mix with applesauce. What should the RN do?

1. AStop the LPN/LVN and contact the prescriber or pharmacist about another form
2. BTell the LPN/LVN to give half of the crushed tablet now and the other half at lunchtime
3. CLet the LPN/LVN continue, since crushing makes the tablet easier to swallow
4. DReport the LPN/LVN at the end of the month without saying anything now

When should the transparent dressing over a peripheral IV site be changed?

1. AWhen it is damp, loose or visibly soiled
2. BOnly when the patient asks for a new dressing
3. CEvery hour, so the site can be cleaned again
4. DOnly when the IV catheter is removed, whatever its state

In US nursing practice, which task should the RN not assign to an LPN/LVN?

1. AReinforcing hand hygiene teaching that the RN has already given
2. BA dressing change on a healing surgical wound that has no signs of infection
3. CThe initial admission assessment of a new patient with suspected sepsis
4. DGiving scheduled oral antibiotics to a stable patient

A blood sample drawn just after a patient ate a fatty meal is reported as "lipemic." What does this mean for the results?

1. AThe sample was contaminated by an IV fluid with dextrose
2. BThe results are more accurate than in a fasting sample
3. CThe sample shows the patient has diabetic ketoacidosis
4. DHigh fat in the sample may interfere with some test results

A 5-year-old has new bruising and petechiae two weeks after a viral illness. Platelets are 12 × 10³/µL; hemoglobin, white cell count and clotting times are normal. Which condition is most likely?

1. ADisseminated intravascular coagulation
2. BImmune thrombocytopenia (ITP)
3. CHemophilia A
4. DAcute leukemia

What is the most common cause of hypernatraemia in frail older inpatients?

1. ANot drinking enough water
2. BEating too much salt in one meal
3. CTaking too many vitamins
4. DToo much exercise

A patient with several days of vomiting and diarrhoea has low blood pressure, low urine output and a rising creatinine. Which description fits best?

1. APost-renal acute kidney injury from obstruction, treated with a catheter
2. BIntrinsic kidney injury from glomerulonephritis, treated with high-dose steroids
3. CChronic kidney disease, treated with long-term dialysis three times a week
4. DPre-renal acute kidney injury from poor perfusion, treated by restoring fluid volume

What is the purpose of a mucolytic such as carbocisteine in chronic productive cough?

1. ATo widen the airways within minutes
2. BTo stop the patient coughing completely, day and night
3. CTo kill bacteria in the airways
4. DTo make sputum thinner and easier to cough up

A smoker has severe shoulder and arm pain, a drooping eyelid, a small pupil and reduced sweating on the same side of the face. What should be suspected?

1. AA simple migraine
2. BA frozen shoulder with referred pain to the face
3. CA stroke affecting the brainstem on the opposite side
4. DA tumour at the apex of the lung (Pancoast tumour)

Which blood gas pattern is typical of acute kidney injury?

1. ALow pH and high carbon dioxide only
2. BHigh pH and low carbon dioxide
3. CHigh pH and high bicarbonate
4. DLow pH and low bicarbonate

Một bệnh nhân nghi đột quỵ đến sau hai giờ kể từ khởi phát. Đường huyết mao mạch là 2,4 mmol/L (43 mg/dL). Bước tiếp theo nên là gì?

1. AĐiều trị đường huyết thấp và đánh giá lại các dấu hiệu thần kinh
2. BCho insulin tĩnh mạch để bảo vệ tế bào não
3. CBỏ qua đường huyết vì không liên quan đến đánh giá đột quỵ
4. DTiêu huyết khối ngay mà không kiểm tra thêm

Why is a gastrostomy tube with an internal bumper usually advanced and rotated regularly once the tract has healed?

1. ATo check that the patient is still hungry
2. BTo make the tube longer as the patient grows or gains weight
3. CTo stop the inner bumper becoming buried in the stomach wall
4. DTo remove any feed left in the stomach

A competent adult who is a Jehovah's Witness refuses blood transfusion before major surgery. What should the nurse do?

1. AAsk the family to override the decision
2. BCancel the surgery without discussing it
3. CRespect the decision, document it and inform the team
4. DPlan to transfuse secretly during the operation if it becomes needed