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

Một điều dưỡng ủy quyền đo dấu hiệu sinh tồn thường quy cho phụ tá điều dưỡng với một người bệnh có huyết áp đang tụt trong một giờ qua. Điều "đúng" nào của ủy quyền không được đáp ứng?

1. AĐúng hoàn cảnh
2. BĐúng người
3. CĐúng hướng dẫn và giao tiếp
4. DĐúng nhiệm vụ, vì dấu hiệu sinh tồn không bao giờ được ủy quyền

An older patient has bruises of different ages and seems frightened when a relative visits. What is the nurse’s priority?

1. AIgnore it, because older people bruise easily
2. BEnsure the patient’s safety, document the findings and report as required
3. CTell the patient she must leave home and go to live somewhere else
4. DAsk the relative directly in front of the patient whether they hit her

A parent will give a liquid antibiotic to a child at home. Which teaching is best?

1. AUse any teaspoon or tablespoon from the kitchen drawer at home
2. BUse a tablespoon for doses over 5 mL
3. CUse the oral syringe or dosing cup that comes with the medicine
4. DEstimate the dose by pouring into a cup

A patient dies after a wrong-drug error, and the hospital carries out a root cause analysis. What is its main focus?

1. AIdentifying which staff member made the error and should be disciplined
2. BDeciding whether to tell the family about the error
3. CFinding the system and process weaknesses that allowed the error
4. DEstimating the legal costs for the hospital

A patient on carbamazepine becomes confused and has a headache. Which laboratory result would most likely explain this?

1. AA low serum sodium
2. BA high serum calcium
3. CA low serum magnesium
4. DA high serum potassium

A patient with heavy alcohol use and a poor diet has a hemoglobin of 10,1 g/dL (101 g/L), an MCV of 110 fL and a low red cell folate. Which explanation fits best?

1. AFolate deficiency, made worse by a direct alcohol effect
2. BIron deficiency from slow, chronic bleeding in the gut
3. CThalassemia trait inherited from one of the parents
4. DAnemia caused by long-standing chronic kidney disease

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

1. ANon-rebreathe mask with reservoir bag at 15 L/min
2. BNasal cannula at 2 L/min
3. CVenturi mask set to 24%
4. DSimple face mask at 5 L/min with the patient sitting up

A patient with poorly controlled hyperthyroidism develops a high fever, very fast heart rate, agitation and vomiting during an infection. What is likely?

1. AThyroid storm
2. BMyxoedema coma
3. CAddisonian crisis
4. DHypoglycaemia

Why is a shock for cardioversion synchronised with the QRS complex?

1. ATo make the shock less painful for the patient
2. BTo keep the pads from burning the skin
3. CTo allow the use of a lower battery charge
4. DTo avoid delivering the shock during the T wave

A patient with pneumonia has a temperature of 39 °C, pain and a sinus tachycardia of 122/min. BP is normal. What is the best way to manage the heart rate?

1. ATreat the fever, pain and possible dehydration, then reassess
2. BGive IV adenosine
3. CArrange urgent electrical cardioversion to restore a normal rate
4. DGive a beta-blocker to bring the heart rate below 100/min

Why is once-daily prednisolone usually taken in the morning with food?

1. ABecause it causes drowsiness and is safer to take during the day
2. BTo match the natural cortisol rhythm and protect the stomach
3. CBecause it cannot be absorbed at night
4. DBecause food doubles the strength of the dose

A 74-year-old falls forward and hits their chin. Their arms are much weaker than their legs, and they have burning pain in the hands. Which injury is most likely?

1. ABrown-Séquard syndrome
2. BCauda equina syndrome
3. CCentral cord syndrome
4. DA complete lumbar cord injury

Một bệnh nhân xuất huyết tiêu hóa trên cấp có hemoglobin bình thường khi đến. Vì sao điều này có thể gây hiểu lầm?

1. AHemoglobin luôn tăng lúc đầu sau bất kỳ mất máu nào
2. BHemoglobin chỉ giảm sau cả một tuần chảy máu liên tục
3. CNó chỉ giảm sau khi dịch chuyển dịch hoặc dịch truyền tĩnh mạch làm loãng máu
4. DHemoglobin không bị ảnh hưởng bởi chảy máu từ ruột

During preoperative assessment, a patient says their brother had a "very high fever" during an anaesthetic. What is the most important action?

1. AGive paracetamol before surgery to prevent fever
2. BReassure the patient that fevers after anaesthesia are always harmless
3. CRecord it as a family allergy to paracetamol
4. DInform the anaesthetist, as malignant hyperthermia may run in the family