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

A patient with diabetes is unresponsive and has a blood glucose of 40 mg/dL (2,2 mmol/L). What should the nurse do first?

1. AWait 15 minutes and recheck the glucose
2. BPour orange juice into the patient’s mouth
3. CGive the scheduled dose of insulin
4. DGive IV dextrose or glucagon as prescribed

A patient admitted with suspected appendicitis says the pain suddenly got better, but now the abdomen is rigid and the heart rate is rising. What does this suggest?

1. AThe pain has moved to a different, harmless place
2. BThe appendix may have ruptured, causing peritonitis
3. CThe appendicitis is getting better without surgery
4. DThe patient’s analgesic has finally started to work

Which practice reduces back strain when a nurse moves a patient or heavy object?

1. AKeep the load close to the body and avoid twisting
2. BStand with the feet close together for balance
3. CHold the load at arm’s length to keep it steady
4. DBend at the waist and keep both knees straight

Một bệnh nhân lú lẫn liên tục giật ống thông mũi–dạ dày. Nên thử cách tiếp cận nào trước?

1. ACố định cổ tay ngay lập tức để bảo vệ ống
2. BMột thuốc an thần để bệnh nhân ngủ yên cả đêm
3. CRút ống mà không hỏi ý kiến cả kíp
4. DCác biện pháp ít hạn chế hơn, như định hướng lại và người trông

A patient with pneumonia had a CRP of 180 mg/L on admission and 40 mg/L after 4 days of antibiotics. What does this most likely show?

1. AThe patient has developed a new infection
2. BThe infection has spread to another organ
3. CThe antibiotic is causing liver damage
4. DThe inflammation is settling with treatment

A patient with a stable INR on warfarin starts rifampin (rifampicin) for tuberculosis. Two weeks later the INR is 1,3. What is the most likely explanation?

1. ARifampin speeds up warfarin metabolism
2. BRifampin contains a lot of vitamin K
3. CTuberculosis causes the INR to fall
4. DRifampin raises the INR, so it is wrong

How is Helicobacter pylori infection usually treated?

1. AAntacids alone, taken after every meal for a month
2. BA single dose of paracetamol and a bland diet for a week
3. CA combination of antibiotics with a proton pump inhibitor
4. DSurgery to remove the stomach

Several hours after thyroid surgery, a patient has increasing neck swelling, stridor and difficulty breathing. What is most likely?

1. AHypocalcaemia from parathyroid damage
2. BA haematoma compressing the airway
3. CNormal postoperative swelling
4. DA thyroid storm

A patient with an implantable cardioverter-defibrillator asks what to do if it fires. Which teaching is correct?

1. AOne shock and well: contact the device clinic; repeated shocks or unwell: call emergency services
2. BIgnore any shock at all, because the device is designed to fire every day and needs no follow-up
3. CRemove the device battery at home if it fires more than once
4. DDrive straight to hospital alone after any shock so the device can be checked by the team

A frightened young woman is breathing fast and has tingling fingers. Her blood gas shows pH 7,50 and a low PaCO₂. SpO₂ is 99% on air. What does this show?

1. AMetabolic acidosis from kidney failure
2. BRespiratory acidosis from hypoventilation
3. CRespiratory alkalosis from hyperventilation
4. DMetabolic alkalosis from vomiting

A patient is starting nitrofurantoin for a UTI. Which teaching point is correct?

1. AIt must be taken only once a week
2. BIt turns the tears and sweat bright orange
3. CIt should be taken on an empty stomach with milk
4. DIt may turn the urine dark yellow or brown

Một bệnh nhân ung thư phổi và SIADH có natri 112 mmol/L và đang co giật. Điều trị nào phù hợp nhất?

1. AUống nhiều nước để làm loãng nước tiểu
2. BGlucose 5% tĩnh mạch tốc độ cao đến khi hết co giật
3. CNước muối ưu trương, có theo dõi, với tốc độ nâng giới hạn
4. DĐiều chỉnh nhanh về 140 mmol/L trong sáu giờ đầu

Which change suggests that a burn wound is becoming infected?

1. ADry, healing skin with mild itching
2. BLess exudate on each dressing change
3. CA partial-thickness burn becoming deeper, with new discolouration
4. DThe wound becoming pink and a little smaller at each dressing change

A patient with active cancer on chemotherapy develops new swelling and pain in one calf. Why must this be reported promptly?

1. AIt is only a muscle strain from walking
2. BCalf swelling is a normal effect of chemotherapy
3. CCancer and its treatment greatly increase clot risk
4. DThe swelling shows the cancer has gone