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

Which patient with diabetes should the nurse see first?

1. AGlucose 210 mg/dL (11,7 mmol/L) after a large lunch, feels well
2. BGlucose 48 mg/dL (2,7 mmol/L), sweating and confused
3. CHbA1c result of 8,2%, asking about diet
4. DNeeds foot care teaching before discharge tomorrow

A nurse returns to the station to find four messages. Which one is answered first?

1. AThe laboratory is calling with a critical potassium result of 2,6 mEq/L
2. BA family member wants an update on their father’s progress
3. CThe pharmacy asks when the next delivery should be scheduled
4. DA colleague asks to swap shifts with them next week because of a family wedding

Which technique is correct when collecting a wound culture?

1. AClean the wound with sterile saline first, then swab clean tissue
2. BSwab the old pus on the dressing that was just removed from the wound
3. CUse one swab to sample two different wounds
4. DCollect the sample only after antibiotics have been started

Một túi thuốc hóa trị rò rỉ xuống sàn. Bước đầu tiên là gì?

1. AĐể cho khô, rồi dọn vào cuối ca
2. BLau nhanh bằng khăn giấy và tay trần
3. CNhờ nhân viên vệ sinh lau bằng cây lau nhà thường dùng
4. DMang trang bị bảo hộ của bộ dụng cụ xử lý tràn đổ và khoanh vùng chỗ tràn

A patient with an upper gastrointestinal bleed has a BUN of 48 mg/dL (urea 17 mmol/L) and a normal creatinine. What is the most likely explanation?

1. ADigested blood adds protein, which the liver turns into urea
2. BSkeletal muscle is breaking down because of the blood loss
3. CThe liver has stopped making urea because of the bleeding
4. DThe kidneys have suddenly lost most of their function

A patient has a positive hepatitis C antibody (anti-HCV) test. What is the most appropriate next step?

1. ATest for HCV RNA to find out whether infection is current
2. BTell the patient they definitely have chronic hepatitis C
3. CRepeat the antibody test, as a positive test is always false
4. DGive hepatitis C vaccine to prevent further infection

Bệnh nhân đang dùng warfarin có INR cao xa khoảng mục tiêu và bầm tím. Thuốc nào có thể được kê để đảo ngược tác dụng?

1. AVitamin K
2. BAspirin
3. CNaloxone
4. DProtamine sulfate

A nurse notices that a wrong dose of a drug was prepared but was caught before it was given. What should be done?

1. ATell only the patient's family
2. BReport it as a near miss through the incident reporting system
3. CSay nothing, because no harm reached the patient
4. DDiscipline the nurse who prepared it on the spot in front of colleagues

A patient is starting doxazosin, an alpha-blocker, for hypertension. Which advice is most important?

1. AAvoid all potassium-containing foods
2. BStop it suddenly if the heart rate rises after the first few doses
3. CTake it with a large glass of grapefruit juice to improve absorption
4. DTake the first dose at bedtime, as dizziness and fainting can occur

A patient being treated for pulmonary TB repeatedly misses doses and stops when they feel better. Which strategy is most effective?

1. ASwitching to a single drug to make it easier
2. BStopping treatment, as it is clearly not working for this patient
3. CDoubling the dose on the days the patient remembers to take it
4. DDirectly observed therapy with support for barriers to adherence

Which complication is a particular risk in nephrotic syndrome?

1. ABleeding from low platelets
2. BLow cholesterol
3. CHypoglycaemia
4. DVenous thrombosis

A drowsy patient's glucose meter shows "HI". What should the nurse do?

1. AAssume the meter is broken and recheck tomorrow
2. BGive glucose gel in case the reading is wrong
3. CTreat it as very high, check ketones and escalate
4. DRecord "normal" in the notes because no number appears

Which is correct when caring for a patient with a PICC line?

1. AAvoid taking blood pressure on the arm with the line
2. BLeave the external length unchecked once it is placed
3. CUse the PICC arm for heavy lifting to keep it flexible
4. DFlush the line only when it blocks

After surgery, a patient keeps asking for analgesia before it is due, watches the clock and rates pain 8/10. What is the most appropriate interpretation?

1. AThe patient is addicted and should have analgesia withheld
2. BThe patient needs only distraction and no change in drugs
3. CThe patient is exaggerating, so the pain scores should be ignored for now
4. DPain may be undertreated; reassess and ask for a review of the plan