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

Two nursing assistants argue loudly at the station about their assignments. What is the charge nurse’s best first step?

1. AIgnore it and hope they sort it out
2. BReport them to human resources at once
3. CMeet both of them privately to hear each side
4. DChange both of their assignments without any discussion

A patient taking an SSRI is also given tramadol. A few hours later the patient is agitated, sweating and has a fever, jerking muscles and brisk reflexes. What is the most likely cause?

1. ASerotonin syndrome
2. BNeuroleptic malignant syndrome
3. CAn anxiety attack
4. DOpioid withdrawal

Khi mở một gói vô khuẩn trên bàn, nếp gấp nào được mở trước?

1. AMở tất cả các nếp cùng lúc
2. BNếp gấp gần điều dưỡng nhất
3. CNếp gấp xa điều dưỡng nhất
4. DNếp gấp bên nào dễ với tới nhất

Which patient should the nurse assess first?

1. AA patient with tuberculosis who is asking to have visitors
2. BA patient who wants more alcohol hand rub in the room
3. CA patient with an MRSA wound due for a routine dressing change
4. DA patient on chemotherapy with a new temperature of 38,4 °C (101,1 °F)

A patient with HIV on antiretroviral therapy has an undetectable viral load. What does this mean?

1. AThe CD4 count must now be dangerously low too
2. BThe treatment can now be stopped without any risk
3. CThe treatment is suppressing the virus very well
4. DThe virus has been completely cured and removed

A patient on a stable dose of levothyroxine now has a TSH of 9,8 mIU/L. She recently started taking her calcium and iron supplements with her morning levothyroxine. What is the most likely explanation?

1. AThe supplements are reducing levothyroxine absorption
2. BThe TSH is low, showing that the dose is now too high
3. CThe supplements are causing an overactive thyroid gland
4. DThe result is normal for a person on levothyroxine therapy

A patient on peritoneal dialysis notices the drained fluid has become cloudy and has abdominal pain. What is likely?

1. AConstipation
2. BNormal dialysis fluid
3. CA urinary tract infection
4. DPeritonitis

A seriously ill patient asks the nurse, "Am I dying?" What is the best initial response?

1. ATell the patient not to think about such things and to stay positive
2. BGently explore what the patient understands and what has prompted the question
3. CChange the subject quickly to keep them cheerful and avoid upsetting them
4. DLeave and send the doctor without saying anything

A young patient with hypertrophic cardiomyopathy asks why they are told to avoid dehydration. What is the best explanation?

1. AFluids dissolve the extra muscle in the heart wall
2. BDehydration makes the heart muscle grow thicker within a few hours
3. CLow blood volume can worsen obstruction of blood leaving the heart
4. DDehydration is the cause of the inherited condition

A nurse reviews inhaler use with a patient who has asthma and uses a separate steroid preventer inhaler and a salbutamol reliever. Which statement shows a need for further teaching?

1. A"I use my steroid inhaler when I start to wheeze."
2. B"I carry my blue reliever inhaler with me."
3. C"I use my steroid inhaler every day, even when I feel well."
4. D"I rinse my mouth after the steroid inhaler."

A patient has taken metformin for many years and now has tingling feet and a low haemoglobin. Which blood test is most relevant?

1. AThyroid antibodies
2. BVitamin B12 level
3. CSerum amylase
4. DBlood alcohol level

A patient had a witnessed tonic-clonic seizure. Afterwards their left arm is weak, and the weakness improves over the next few hours. What is the best interpretation?

1. APossible postictal (Todd's) paresis, but a stroke must still be excluded
2. BNormal postictal tiredness that needs no further assessment or imaging at all
3. CCertainly a stroke, so the seizure can be ignored
4. DA sign that the patient is pretending to be weak

Why are carbohydrate drinks often given before surgery in enhanced recovery programmes?

1. ATo reduce insulin resistance and improve recovery
2. BTo replace the need for any IV fluids afterwards
3. CTo make the bowels open before the operation
4. DTo raise the blood pressure during the anaesthetic

Two hours after a meal, a patient who had a gastrectomy becomes shaky, sweaty and confused. What is the most likely cause and first action?

1. AAn anastomotic leak; insert a nasogastric tube at once
2. BLate dumping with low blood glucose; check capillary glucose
3. CVitamin B₁₂ deficiency; give an injection now
4. DEarly dumping from fluid shifts; give a large drink of water