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

On a pediatric unit, which child does the nurse assess first?

1. AA child in a new arm cast with pink, warm fingers and pain of 5/10
2. BA child with croup who has a barking cough but no stridor at rest
3. CA child with asthma who is now quiet with very little air movement
4. DA child with a temperature of 38,2 °C after vaccination

During JumpSTART triage, a child is not breathing after the airway is opened but has a palpable pulse. What is the next step?

1. AGive five rescue breaths; if breathing starts, tag the child red
2. BTag the child green and return to them after the others
3. CStart full CPR on the child and stay with them until more help arrives
4. DTag the child black at once and move on to the next victim

Many intensive care units bathe patients daily with chlorhexidine. What is the main purpose?

1. ATo lower the patient’s body temperature
2. BTo moisturize dry skin in older patients
3. CTo treat existing wound infections without the need for antibiotics
4. DTo reduce skin bacteria and bloodstream infections linked to central lines

A nurse sees a doctor about to insert a central line without a sterile gown, and a polite comment was ignored. Which TeamSTEPPS phrase helps to stop the procedure?

1. A“I am concerned, I am uncomfortable, this is a safety issue.”
2. B“I am sure you know what you are doing.”
3. C“Let’s talk about it after you have finished.”
4. D“I will mention this to the manager at the next staff meeting.”

Khi nào người bệnh bệnh thận mạn nên dùng thuốc gắn phosphate như calci acetate hoặc sevelamer?

1. ATrước khi đi ngủ lúc bụng đói
2. BChỉ khi người bệnh cảm thấy không khỏe
3. CChỉ một lần mỗi tuần
4. DCùng bữa ăn

A patient has painless jaundice, itching, dark urine and pale stools. ALP is markedly raised, conjugated (direct) bilirubin is high and ALT is only mildly raised. What is the most likely cause?

1. ABlockage of bile flow, for example by a tumor in the bile duct
2. BIncreased breakdown of red blood cells (hemolytic anemia)
3. CAcute viral hepatitis with widespread liver cell damage
4. DGilbert syndrome, a harmless inherited bilirubin disorder

Thuốc tiêu sợi huyết đường tĩnh mạch nhìn chung được cho trong khoảng thời gian nào đối với đột quỵ thiếu máu não cấp?

1. AChỉ sau 24 giờ
2. BBất kỳ lúc nào trong vòng một tuần
3. CTrong vòng 4,5 giờ kể từ khi khởi phát triệu chứng
4. DTrong vòng 48 giờ kể từ khi khởi phát triệu chứng

A patient is admitted with suspected meningococcal disease. Which infection control measure is usually needed?

1. AAirborne precautions with a negative-pressure room for the whole hospital stay
2. BIsolation only after the patient has gone home
3. CDroplet precautions until 24 hours of effective antibiotics have been given
4. DNo precautions, because it is not contagious

After a bronchoscopy with throat anaesthesia, when can the patient eat and drink?

1. AWhen the gag and cough reflexes have returned
2. BImmediately after the scope is removed
3. CAfter a full 24 hours without food
4. DOnly after a chest X-ray has been reported

During drainage of a large pleural effusion, a patient starts coughing and feels tight in the chest. What should the nurse do?

1. ASpeed up the drainage to finish quickly
2. BStop or clamp the drainage and inform the doctor
3. CAsk the patient to cough harder to help the flow
4. DLie the patient flat until the drainage is complete

A patient on peritoneal dialysis has gained weight and has higher glucose levels. Which part of the treatment is the likely cause?

1. ASodium lost into the dialysis fluid
2. BProtein lost into the dialysis fluid
3. CAir entering the abdomen during exchanges
4. DGlucose absorbed from the dialysis fluid

A patient with gastroparesis has hypos soon after their meal-time insulin, then high glucose several hours later. What is the best explanation?

1. AThe insulin has gone off and needs replacing
2. BThe patient is secretly eating sweets between meals
3. CFood is absorbed slowly, so the insulin peaks before the glucose rises
4. DThe meter gives false results for several hours after every meal

Which advice helps prevent dumping syndrome after gastrectomy?

1. AA high-sugar diet with fruit juice to keep energy levels up
2. BSit upright and walk briskly straight after every meal
3. CThree large meals a day with plenty of sweet drinks with each meal
4. DSmall, frequent meals low in simple sugars, with fluids between meals

Chiến lược truyền dịch nào nhìn chung được khuyến cáo trong những giờ đầu của viêm tụy cấp?

1. AThể tích rất lớn, bất kể đáp ứng của bệnh nhân
2. BDịch tinh thể cân bằng theo mục tiêu, hướng dẫn bởi đáp ứng
3. CChỉ albumin tĩnh mạch thay cho bất kỳ dịch tinh thể nào
4. DKhông truyền dịch tĩnh mạch, chỉ nhấp từng ngụm nước nhỏ