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

A patient arrives in the recovery room after general anesthesia. What does the nurse assess first?

1. AAirway patency and breathing
2. BThe pain score
3. CThe surgical dressing and the drains
4. DUrine output

A victim heavily contaminated with an industrial chemical arrives at the emergency department with stable vital signs. What should happen first?

1. AFull assessment inside the main department straight away
2. BTaking the victim straight to the X-ray department
3. CPlacing the victim in the waiting room until a doctor is free
4. DDecontamination before the victim enters the treatment area

A small spill of blood is found on the floor. How should it be cleaned?

1. AWipe it up quickly with a dry cloth using bare hands, then wash the hands well
2. BCover it with a clean sheet and keep working
3. CLeave it until housekeeping arrives the next morning
4. DWear gloves, absorb the blood, then clean the area with an approved disinfectant

While preparing a chemotherapy infusion, the drug splashes onto a nurse’s forearm. What should the nurse do first?

1. AFinish hanging the infusion and then wash the skin
2. BRemove contaminated PPE and wash the skin with soap and water at once
3. CWipe the skin with an alcohol swab and continue preparing the infusion
4. DCover the area with a dressing and report later

A test has very high sensitivity for a disease. What does a negative result mean?

1. AThe disease is unlikely, so it helps rule it out
2. BThe result cannot be used, because sensitivity is high
3. CThe disease is certain, so treatment should begin
4. DThe patient must have a different disease instead

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

A patient on haemodialysis has an arteriovenous fistula in the left arm. Which nursing care is correct?

1. AAvoid blood pressure readings and blood samples on that arm
2. BUse the fistula arm for routine IV cannulas
3. CKeep the arm raised and still at all times
4. DApply a tight bandage over the fistula at night to protect it

A postoperative patient on IV fluids has a sodium of 128 mmol/L and is becoming confused. Which fluid could make this worse if given in large amounts?

1. AHartmann's solution (similar to lactated Ringer's)
2. B0,9% sodium chloride
3. C5% glucose (D5W)
4. DHuman albumin solution

A patient's capillary refill time at the fingertip is 4 seconds. What does this suggest?

1. ANormal peripheral perfusion
2. BA high haemoglobin level
3. CAn unusually strong cardiac output
4. DReduced peripheral perfusion

A 70-year-old man has a small abdominal aortic aneurysm found on screening and is placed under surveillance. Which advice is most important?

1. AHave the aneurysm repaired immediately, whatever its size or growth rate
2. BAvoid all exercise and lifting for the rest of his life to protect the aorta
3. CStop all blood pressure medicines to avoid low pressure
4. DStop smoking, control BP and seek help at once for sudden back pain

A patient has acute low back pain with no red flags. Which advice is most appropriate?

1. AStay as active as possible and use simple pain relief
2. BStay in bed for two weeks until the pain is gone
3. CWear a rigid back brace all day and night for at least three months
4. DAvoid all movement until an MRI scan has been done

A patient on insulin has worsening chronic kidney disease and is having more hypos. What is the best explanation?

1. AThe kidneys clear less insulin, so it lasts longer
2. BThe patient is eating far more carbohydrate than before
3. CKidney disease makes the meter read too low
4. DKidney disease makes the body resistant to insulin

Which statement about corticosteroids in inflammatory bowel disease is correct?

1. AThey are used to induce remission, not for maintenance
2. BThey are given only as a one-off injection
3. CThey are the best long-term maintenance treatment
4. DThey cure the disease after one course

A patient with a sacral pressure ulcer keeps sliding down the bed when the head is raised high. Which advice best reduces shear?

1. AKeep the head of the bed at or below 30° if possible; use slide sheets
2. BSit the patient upright without any support for the feet
3. CUse a dry sheet and drag the patient up the bed
4. DRaise the head of the bed to 90° and pull the patient up the bed by the arms