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

A patient had a colostomy formed yesterday. Which stoma appearance should be reported straight away?

1. ASlightly swollen
2. BMoist and pink-red
3. CDark purple or black
4. DA little bleeding when cleaned

A patient opens their eyes only to pain, uses inappropriate words and withdraws from pain. What is the Glasgow Coma Scale score?

1. A7
2. B9
3. C11
4. D13

A family member will visit a patient on contact precautions. What should the nurse do?

1. AShow them how to use the gown and gloves and how to clean their hands
2. BTell them precautions only apply to staff
3. CAsk them to wear an N95 respirator only, with no gown or gloves
4. DTell them visits are not allowed at all

Bệnh nhân được kê hydralazine, nhưng khoa dược gửi hydroxyzine. Điều dưỡng nên làm gì?

1. ACho nửa liều hydroxyzine như một thỏa hiệp
2. BCho ngay bây giờ và báo người kê đơn sau
3. CKhông cho thuốc, và liên hệ khoa dược để lấy đúng thuốc
4. DCho thuốc, vì hai tên thuốc gần như giống nhau

A patient on levothyroxine has palpitations, weight loss and a TSH of 0,05 mIU/L. What is the most likely explanation?

1. AThe levothyroxine dose is too low
2. BThe patient has stopped the drug
3. CThe levothyroxine dose is too high
4. DThe thyroid is now completely normal

Một người bệnh có số lượng tiểu cầu 35 × 10³/µL được kê tiêm bắp. Điều dưỡng nên làm gì?

1. ATiêm theo y lệnh và xoa bóp chỗ tiêm mạnh
2. BHỏi người kê đơn xem có thể dùng đường khác không
3. CTiêm và chườm nóng
4. DTiêm bằng kim dài hơn

A dying patient can no longer drink and has a dry mouth. What is the most appropriate nursing care?

1. AInserting a nasogastric tube for fluids
2. BFrequent mouth care that keeps the lips and mouth moist
3. CLeaving the mouth alone to avoid disturbing them
4. DStarting a fast intravenous infusion to correct the dryness

A patient rescued from a house fire has soot around the mouth, singed nasal hairs and a hoarse voice. What is the main concern?

1. AA minor throat infection
2. BDehydration from sweating
3. CAirway swelling from inhalation injury
4. DHypothermia from the fire service water

Which advice is most helpful for a patient with Raynaud's phenomenon?

1. ARub the fingers hard with snow during an attack
2. BSoak the hands in cold water to toughen the vessels
3. CTake a decongestant tablet before going outdoors
4. DKeep the whole body warm, wear gloves and stop smoking

A ventilated patient suddenly desaturates to 82%. The cause is not obvious and the ventilator alarms are sounding. What should the nurse do first?

1. ADisconnect and hand-ventilate with 100% oxygen while calling for help
2. BSilence the alarm and wait for the result of the next routine blood gas
3. CIncrease the sedation and watch the monitor for the next half hour
4. DChange the ventilator settings to a higher rate

Một bệnh nhân dùng dapagliflozin (thuốc ức chế SGLT2) đang nôn, ceton máu 4,5 mmol/L nhưng đường huyết chỉ 11 mmol/L. Cần nghi ngờ điều gì?

1. ATrạng thái tăng áp lực thẩm thấu tăng đường huyết
2. BMột tác dụng phụ bình thường không cần xử trí
3. CNhiễm toan ceton đái tháo đường với đường huyết bình thường (euglycaemic DKA)
4. DHạ đường huyết do nôn

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. AIgnore it, because stress always raises glucose
2. BGive glucose gel to stabilise the level
3. CReport it and monitor glucose, as it can worsen outcome
4. DStop all IV fluids to lower the glucose

For which stoma can colostomy irrigation be considered?

1. AA new ileostomy in the first week
2. BAn established descending or sigmoid colostomy
3. CAny stoma that has liquid or very loose output
4. DAn ileal conduit draining urine

A patient arrives in the anaesthetic room without an identity band. What should the nurse do?

1. AProceed because the patient can say their name
2. BProceed and add a band once in recovery
3. CStop and confirm identity, then apply a band
4. DUse the spare identity band from the front of the patient's notes folder