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

An older patient becomes confused over a few hours, with attention that comes and goes. What does this suggest?

1. AA personality change that is permanent and expected
2. BDelirium, which needs the cause found quickly
3. CNormal aging that needs no action
4. DLong-standing dementia that is expected

A victim heavily contaminated with an industrial chemical arrives at the emergency department with stable vital signs. What should happen first?

1. AFull assessment inside the main department straight away
2. BPlacing the victim in the waiting room until a doctor is free
3. CTaking the victim straight to the X-ray department
4. DDecontamination before the victim enters the treatment area

Cách thực hành nào về thiết bị là đúng đối với bệnh nhân đang áp dụng phòng ngừa tiếp xúc?

1. ADùng ống nghe và vòng bít đo huyết áp riêng cho bệnh nhân đó
2. BLấy thiết bị từ kho sạch và để lại nguyên như cũ
3. CDùng cùng một ống nghe cho mọi bệnh nhân mà không lau sạch
4. DMang thiết bị của bệnh nhân sang phòng kế bên

A chemical cloud has been released near the hospital, and authorities order “shelter in place”. What should staff do?

1. ASend all visitors home through the main entrance
2. BOpen the windows to let fresh air into the wards and dilute the chemical
3. CKeep everyone inside, close windows and doors and shut off outside air intake
4. DEvacuate all patients into the car park at once

A young adult with new diabetes has a very low C-peptide level. What does this suggest?

1. AThe patient is injecting too much insulin and needs a lower dose
2. BThe pancreas is making very little insulin, as in type 1 diabetes
3. CThe patient has high insulin resistance, as in type 2 diabetes
4. DThe kidneys are excreting all of the patient's insulin in urine

A patient with ongoing hemolytic anemia has an HbA1c of 4,6%, but home glucose readings are often 180–220 mg/dL (10–12 mmol/L). What best explains the gap?

1. AShort red cell life span lowers the HbA1c falsely
2. BThe home glucose meter is reading falsely high
3. CThe patient has true, well-controlled diabetes
4. DHemolysis makes the HbA1c test read too high

A spontaneously breathing patient is critically ill and hypoxic. Which oxygen delivery gives the highest concentration?

1. ANasal cannula at 2 L/min
2. BSimple face mask at 5 L/min with the patient sitting up
3. CNon-rebreathe mask with reservoir bag at 15 L/min
4. DVenturi mask set to 24%

A healthcare assistant reports four observations. Which one needs the nurse's immediate action?

1. A"Mr Chen's blood pressure is 128/80 as usual."
2. B"Mrs Jones would like a cup of tea and her glasses cleaned."
3. C"Mr Patel's breathing rate is 8 a minute and he's hard to wake."
4. D"Ms Ali has walked to the bathroom on her own."

How is orthostatic (postural) hypotension usually assessed?

1. ABP once sitting, then once lying down straight after a large meal
2. BBP in both arms at the same moment while sitting
3. CBP lying after rest, then again after 1 and 3 minutes standing
4. DBP only standing, after a brisk walk along the corridor

Một người 82 tuổi bị viêm phổi mắc phải cộng đồng, mới lú lẫn, nhịp thở 32/phút, huyết áp 88/52 mmHg và urê 9 mmol/L. Điều này cho thấy gì?

1. AĐiểm CURB-65 là 1: phù hợp dùng kháng sinh đường uống tại nhà
2. BĐiểm CURB-65 là 5: nguy cơ cao, cần bác sĩ cấp cao đánh giá khẩn
3. CMột đáp ứng bình thường với nhiễm trùng ở người cao tuổi
4. DĐiểm CURB-65 là 3: chỉ nhập khoa thường theo quy trình

A patient on ciclosporin or tacrolimus asks about grapefruit juice. Which advice is correct?

1. ADrink it with each dose to improve the absorption
2. BIt has no effect on these drugs
3. CDrink it daily to protect the kidney
4. DAvoid it, because it can raise the drug levels

A patient with a long-term catheter has fever and rigors, and a catheter UTI is suspected. Which action is recommended before starting antibiotics?

1. ARemove the catheter and leave it out permanently
2. BFlush the catheter with saline and continue
3. CTake a sample from the drainage bag and send it to the lab
4. DReplace the catheter and take a sample from the new one

Which initial treatment is usual for symptomatic hypercalcaemia of malignancy?

1. AFluid restriction and a thiazide diuretic
2. BIV fluids followed by an IV bisphosphonate
3. CA high-calcium diet with extra milk
4. DOral calcium tablets and vitamin D

On the day after a Hartmann's procedure, the end colostomy is dark purple to black. What should the nurse do?

1. ACut a smaller hole in the pouch
2. BRecord it as normal postoperative bruising and recheck it next week
3. CReport it urgently, as the stoma may be necrotic
4. DRub the stoma to improve its colour