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

A nurse gives IV morphine for severe pain. When should the nurse reassess the pain and sedation?

1. AOnly when the patient asks for more
2. BAt the next routine round in four hours
3. CAt the end of the shift
4. DWithin about 15–30 minutes

Phân công nào cho LPN/LVN là phù hợp nhất?

1. ANgười bệnh rung nhĩ mới vừa bắt đầu truyền diltiazem tĩnh mạch
2. BNgười bệnh cần hướng dẫn xuất viện về warfarin mới bắt đầu
3. CNgười bệnh chuyển từ hồi sức tích cực xuống một giờ trước
4. DNgười bệnh COPD ổn định cần khí dung giãn phế quản theo lịch và thuốc uống

Where is a gait belt placed when helping a patient to walk?

1. AAround both thighs, just above the knees
2. BAround the chest, under the arms
3. CAround the hips, directly on bare skin
4. DAround the patient’s waist, over clothing

Minutes after the first IV dose of an antibiotic starts, the patient develops wheezing, hives and low blood pressure. What should the nurse do first?

1. AGive an oral antihistamine
2. BStop the infusion
3. CSlow the infusion rate
4. DRecord the new allergy in the chart

Vì sao người bệnh bệnh thận mạn thường bị thiếu máu?

1. AThận tạo ra ít erythropoietin hơn, hormone thúc đẩy sản xuất hồng cầu
2. BThận bị tổn thương lọc bỏ và phá hủy hồng cầu
3. CĐộc tố urê huyết làm tủy xương sản xuất bạch cầu thay vì hồng cầu
4. DKali cao trong bệnh thận phá vỡ hồng cầu

A patient taking an SGLT2 inhibitor has nausea and fast breathing. Glucose 190 mg/dL (10,5 mmol/L), pH 7,15, bicarbonate 10 mEq/L, blood ketones high. What is the most likely diagnosis?

1. AEuglycemic diabetic ketoacidosis
2. BSimple fasting ketosis only
3. CHyperosmolar hyperglycemic state
4. DRespiratory acidosis from COPD

Which blood result often rises in an upper GI bleed because blood is digested in the gut?

1. AGlucose
2. BCalcium
3. CSodium
4. DUrea (blood urea nitrogen)

Why are early surgery and early mobilisation recommended for older patients with a hip fracture?

1. AThey mainly reduce the cost of the operation
2. BThey allow the bone to heal fully without any need for pain relief
3. CThey reduce complications such as pneumonia, pressure ulcers and delirium
4. DThey make physiotherapy and rehabilitation unnecessary after discharge

A patient with a mechanical heart valve asks to switch from warfarin to apixaban. What is the correct response?

1. ADirect oral anticoagulants are not used for mechanical valves
2. BMechanical valves do not need anticoagulation after the first month
3. CAspirin alone can replace warfarin once the valve has healed
4. DAny anticoagulant works equally well once the valve is in place

A patient with heart failure wakes extremely breathless, coughing pink frothy sputum. BP is 168/96 mmHg and SpO₂ 86%. Help has been called. What is the best initial nursing action?

1. AGive a large IV fluid bolus to support the circulation
2. BEncourage the patient to walk to ease the breathing
3. CLie the patient flat with the legs raised on pillows
4. DSit the patient upright with the legs down and give oxygen

A patient with a new ileal conduit has threads of mucus in their urine. What should the nurse explain?

1. AThe kidneys have stopped working properly after surgery
2. BThis proves a serious kidney infection
3. CThis is normal, because the conduit is made from bowel
4. DThis is a sign that the stoma is dying

A patient is being assessed for brain death (brainstem death). Which condition must be excluded before testing?

1. AA haemoglobin of 110 g/L (11 g/dL)
2. BEffects of sedative drugs or severe hypothermia
3. CA history of high blood pressure
4. DA previous episode of migraine

Why are accurate fluid balance charts kept after major surgery?

1. ATo record when visitors come and go
2. BTo detect dehydration, fluid overload or kidney problems early
3. CTo decide which meal the patient will have next
4. DTo check how far the patient has walked and how often they get out of bed

During preoperative assessment, a patient says their brother had a "very high fever" during an anaesthetic. What is the most important action?

1. AReassure the patient that fevers after anaesthesia are always harmless
2. BInform the anaesthetist, as malignant hyperthermia may run in the family
3. CRecord it as a family allergy to paracetamol
4. DGive paracetamol before surgery to prevent fever