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

A drowsy patient who has just returned from surgery starts to vomit. What should the nurse do first?

1. AGive an oral anti-sickness tablet
2. BGive a drink of water
3. CRaise the legs above the heart
4. DTurn the patient onto their side

A severely malnourished patient started nutrition two days ago and now has weakness and confusion. Which laboratory result should the nurse check first?

1. ASerum amylase
2. BThyroid hormone
3. CSerum cholesterol
4. DSerum phosphate

Why are blood cultures usually taken from two separate venipuncture sites?

1. ATo make the results come back faster from the laboratory
2. BBecause each site tests a different antibiotic
3. CTo help tell a true infection from skin contamination
4. DTo reduce the total amount of blood taken

Which patient with a suspected infection meets the qSOFA criteria that signal a higher risk of a poor outcome?

1. ARespiratory rate 18/min, alert, systolic BP 130 mmHg, temperature 38,5 °C
2. BRespiratory rate 16/min, alert, systolic BP 105 mmHg, WBC 13,000/mm³
3. CRespiratory rate 24/min, new confusion, systolic BP 95 mmHg
4. DRespiratory rate 20/min, alert, systolic BP 110 mmHg, heart rate 110/min

When several samples are drawn at the same venipuncture, which tubes or bottles are filled first?

1. ABlood culture bottles
2. BEDTA (complete blood count) tubes
3. CCoagulation (citrate) tubes
4. DFluoride (glucose) tubes

An RN cares for a patient on a 24-hour urine collection. Which task can be delegated to unlicensed assistive personnel (UAP), such as a nursing or healthcare assistant?

1. ASaving all urine in the collection container as instructed
2. BDeciding whether to restart the collection after a missed sample
3. CInterpreting the creatinine clearance result when it comes back
4. DTeaching the patient why the 24-hour collection is needed

Bệnh nhân giảm bạch cầu trung tính sau hóa trị có nhiệt độ 38,3 °C. Ưu tiên là gì?

1. AXử trí như nhiễm khuẩn huyết ở bệnh nhân giảm bạch cầu trung tính và cho kháng sinh tĩnh mạch khẩn cấp
2. BChỉ cho paracetamol và kiểm tra lại nhiệt độ vào ngày mai
3. CKhuyến khích bệnh nhân đi dạo
4. DChờ 24 giờ xem cơn sốt có hạ không

Which feature best distinguishes delirium from dementia?

1. ADementia always causes visual hallucinations
2. BDelirium only affects people under 50, while dementia affects older people
3. CDelirium is permanent, while dementia is reversible
4. DDelirium starts suddenly and fluctuates, while dementia develops gradually

A patient on furosemide has a serum potassium of 3,0 mmol/L (3,0 mEq/L). Which symptoms may this cause?

1. ATingling around the lips and painful spasm of the hands
2. BMuscle weakness, cramps and an irregular pulse
3. CFacial flushing, fever and a skin rash
4. DSevere headache and a stiff neck

A healthcare assistant (unlicensed assistive personnel) reports four observations. Which one needs the nurse's attention first?

1. AA patient with a DVT whose leg is less swollen today
2. BA patient with heart failure who is newly confused, with SpO₂ 89%
3. CA patient after a PCI asking for a cup of tea
4. DA patient with COPD whose SpO₂ is 90% on 1 L/min, which is usual for him

Trước khi tiêu huyết khối tĩnh mạch cho đột quỵ, giới hạn huyết áp nào thường được dùng?

1. AKhông có giới hạn huyết áp
2. BTrên khoảng 200/120 mmHg
3. CDưới khoảng 90/60 mmHg
4. DDưới khoảng 185/110 mmHg

A nurse teaches a carer to give buccal midazolam for prolonged seizures. Which statement shows a need for further teaching?

1. A"I will call an ambulance if the care plan tells me to."
2. B"I will put something between his teeth so he does not bite his tongue."
3. C"I will give it into the space between his gum and cheek."
4. D"I will write down the time the seizure started and the time I gave the dose."

Before an anti-TNF biologic such as infliximab is started for Crohn's disease, which screening is essential?

1. AA test for coeliac disease
2. BScreening for tuberculosis
3. CA bone density scan
4. DA test of colour vision

Hours after an oesophageal dilatation, a patient has chest pain, fever and crackling swelling under the skin of the neck. What should the nurse suspect?

1. ANormal discomfort after the procedure
2. BAn allergic reaction to the sedative
3. CSimple reflux after the dilatation
4. DOesophageal perforation