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

A patient with heart failure gained 2 kg (about 4 lb) since yesterday and is more breathless when lying down. What should the nurse do first?

1. AEncourage extra fluids to correct the weight change
2. BRecord the weight on the chart and recheck it at the next weekly weigh-in
3. CAssess the lungs, oxygen saturation and swelling, then inform the provider
4. DLay the patient flat to help them breathe more easily

A patient is deteriorating quickly. The nurse has called the provider twice, but the provider has not come. What is the best action?

1. AWait another hour and call the provider again
2. BActivate the rapid response team
3. CDocument the concern and continue routine care
4. DAsk the patient’s family to call the provider

After teaching a patient about a new medication, how does the nurse best check understanding?

1. AAsk the patient to explain in their own words how and when to take it
2. BGive a printed leaflet about the drug and assume the patient will read it at home
3. CAsk the family whether they understood the teaching
4. DAsk “Do you understand?” and accept a yes

A child with fever, cough, red eyes and a spreading rash is in a clinic waiting room. Measles is suspected. What should the nurse do first?

1. AGive the child an antipyretic and continue triage
2. BSend the child home to rest without an assessment
3. CAsk the family to wait in the main waiting room until the child is called in
4. DPut a mask on the child and move them into an airborne isolation room

A patient starts high-dose prednisone. Which laboratory change should the nurse expect?

1. AA rise in serum potassium
2. BA rise in blood glucose
3. CA fall in serum sodium
4. DA fall in the white cell count

Vì sao creatinine bình thường có thể gây hiểu lầm ở người cao tuổi suy yếu, khối cơ thấp?

1. AÍt cơ tạo ra ít creatinine, che lấp chức năng thận giảm
2. BNgười cao tuổi luôn có creatinine cao hơn người trẻ
3. CCreatinine bình thường luôn chứng tỏ chức năng thận bình thường
4. DNồng độ creatinine hoàn toàn không phụ thuộc vào khối cơ

Why are patients encouraged to use an incentive spirometer after abdominal surgery?

1. ATo measure their lung function so the result can go in the discharge letter
2. BTo encourage deep breaths that prevent atelectasis and chest infection
3. CTo lower their heart rate before mobilising
4. DTo strengthen the abdominal muscles around the wound

A patient with severe sepsis starts bleeding from cannula sites and the gums, with a low platelet count and prolonged clotting times. What is most likely?

1. AAn allergic reaction to the cannula
2. BVitamin C deficiency
3. CDisseminated intravascular coagulation
4. DHaemophilia A

After a prescribed IV fluid bolus for hypotension, what should the nurse do next?

1. AWait until the next routine observations in four hours
2. BStart a second fluid bolus straight away without checking anything
3. CReassess heart rate, blood pressure, urine output and lung sounds
4. DStop all monitoring if the patient says they feel better

Ống dẫn lưu ngực của bệnh nhân bị tuột khỏi bình dẫn lưu. Điều dưỡng nên làm gì trước tiên?

1. ARút ống dẫn lưu khỏi ngực và che vị trí
2. BKẹp ống vài giờ và kiểm tra lại bệnh nhân sau
3. CĐể hở ra không khí cho đến khi bác sĩ đến xem
4. DNối lại, hoặc nhúng đầu ống vào nước vô khuẩn, rồi đánh giá

An older patient with a long-term catheter has bacteria in the urine but no symptoms. What is usually appropriate?

1. AAntibiotics for life to keep the urine sterile
2. BA full course of antibiotics straight away
3. CNo antibiotics, as long as there are no symptoms
4. DRemove the catheter permanently at once

Một bệnh nhân vừa được tạo lỗ rò động–tĩnh mạch ở cánh tay trái hôm qua và cần xét nghiệm máu thường quy. Hướng dẫn nào quan trọng nhất?

1. AQuấn chặt cánh tay trái bằng băng để bảo vệ lỗ rò
2. BDùng garo chặt ở cánh tay trái để tìm tĩnh mạch tốt
3. CDùng cánh tay phải; kiểm tra tuần hoàn bàn tay trái và rung miu
4. DLấy máu từ lỗ rò, vì dễ tìm và to

What is achalasia?

1. AA tear at the junction of the oesophagus and the stomach
2. BFailure of the lower oesophageal sphincter to relax on swallowing
3. CInflammation of the oesophagus caused by a fungal infection
4. DWeakness of the lower oesophageal sphincter that allows reflux

A patient with diabetes has rapidly spreading redness around a small wound, severe pain out of proportion, fever and crackling under the skin. What should the nurse suspect?

1. ANecrotising fasciitis
2. BMild contact dermatitis
3. CA simple insect bite
4. DA healing venous ulcer