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

A nurse teaches a patient who has started warfarin. Which statement shows a need for further teaching?

1. A“I will keep my INR blood test appointments.”
2. B“I will use a soft toothbrush.”
3. C“If I miss a dose, I will take two the next day.”
4. D“I will tell my dentist and pharmacist that I take warfarin.”

A patient with raised intracranial pressure is being nursed on the ward. Which position is best?

1. AHead of the bed at about 30 degrees with the neck straight
2. BHead down with the legs raised above the heart
3. CFlat on the back with the head turned well over to one side
4. DSitting forward with the chin on the chest

A nurse who never had BCG vaccine has a positive tuberculin skin test for the first time. The chest x-ray is clear and there are no symptoms. What does this most likely mean?

1. ALatent TB infection, which is not contagious
2. BActive TB, which needs airborne isolation
3. CA failed test that must be repeated next year
4. DImmunity to TB from a past exposure

A nurse teaches parents about using an infant car seat. Which statement shows a need for further teaching?

1. A“We will use the car seat for every trip, even short ones.”
2. B“We will put the rear-facing seat in the front so we can see the baby.”
3. C“We will make sure the harness straps are snug against the baby’s chest.”
4. D“We will install the seat in the back seat, facing the rear.”

A urine culture report states "mixed growth of three organisms, likely contamination." What is the nurse's best response?

1. AStart treatment for all three organisms with three antibiotics
2. BInform the provider and arrange a new, correctly collected sample
3. CDiscard the report, because a mixed growth is always normal
4. DRecord the result as a confirmed urinary tract infection

A patient's creatinine was 0,9 mg/dL (80 µmol/L) on admission and is 1,3 mg/dL (115 µmol/L) 36 hours later. Using the common KDIGO criteria, what does this show?

1. ANo kidney injury, because the creatinine is still within the normal range
2. BA laboratory error, because creatinine cannot change within 2 days
3. CChronic kidney disease, because creatinine has risen above baseline
4. DAcute kidney injury, because it rose by at least 0,3 mg/dL within 48 hours

Why does a patient with a suspected TIA need urgent specialist assessment?

1. AThe patient needs urgent surgery on the brain
2. BThe symptoms will come back permanently within an hour
3. CA TIA always turns into a brain tumour unless it is treated
4. DThe risk of a full stroke is highest in the days after a TIA

A patient with known prostate cancer reports new back pain, leg weakness and difficulty passing urine. What should be suspected?

1. AMetastatic spinal cord compression
2. BSimple mechanical back pain
3. CA urinary tract infection spreading to the back
4. DHypokalaemia

Which exercise advice is recommended for intermittent claudication?

1. AStopping walking at the very first twinge of pain each time
2. BComplete bed rest until the leg pain has gone for at least a month
3. CWalking only on days when the legs feel warm and painless
4. DSupervised walking until pain is near maximal, then rest and repeat

A hypotensive patient has a temperature of 39,2 °C, warm flushed skin, a bounding pulse and a fast heart rate. Which type of shock is most likely?

1. AHypovolaemic shock from bleeding
2. BObstructive shock from tamponade
3. CCardiogenic shock
4. DEarly septic (distributive) shock

A patient has confirmed meningococcal meningitis. What is usually offered to their close household contacts?

1. AA lumbar puncture to check for infection
2. BNo action unless they develop symptoms
3. CA full course of IV antibiotics in hospital
4. DPreventive antibiotics

A patient with an acute stroke has a glucose of 15 mmol/L (270 mg/dL). They do not have known diabetes. What is appropriate?

1. AGive glucose gel to stabilise the level
2. BIgnore it, because stress always raises glucose
3. CStop all IV fluids to lower the glucose
4. DReport it and monitor glucose, as it can worsen outcome

Why are patients with diabetes often placed early on the operating list?

1. ABecause their surgery always takes longer than others
2. BBecause they need to go home before midday
3. CTo shorten fasting and reduce swings in blood glucose
4. DBecause their wounds heal faster in the morning

After surgery, a patient says they have "no pain" but grimaces, breathes shallowly and refuses to move or cough. What should the nurse do?

1. AExplore their beliefs and explain how analgesia aids recovery
2. BAccept the statement and record a pain score of 0
3. CInsist they walk without any analgesia
4. DTell the patient firmly that they must stop hiding their pain from staff