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

Which patient is at the highest risk of falling?

1. AA 60-year-old admitted for chest pain that has since been ruled out by tests
2. BA 30-year-old after an appendectomy who walks with steady steps
3. CA 45-year-old with asthma who is alert and independent
4. DAn 84-year-old taking a diuretic who has fallen before and gets up at night

Một ê-kíp gồm RN, LPN/LVN và phụ tá điều dưỡng. Phân công nào phù hợp nhất?

1. APhụ tá: ca nhập mới; LPN/LVN: chăm sóc vệ sinh; RN: dấu hiệu sinh tồn thường quy ở người bệnh ổn định
2. BPhụ tá: thuốc uống; LPN/LVN: kế hoạch chăm sóc; RN: chăm sóc vệ sinh cho người bệnh ổn định
3. CRN: ca nhập mới; LPN/LVN: thuốc cho người bệnh ổn định; phụ tá: vệ sinh
4. DLPN/LVN: mọi đánh giá ban đầu; RN: thuốc theo lịch; phụ tá: hướng dẫn xuất viện

Which technique is used for suctioning a tracheostomy in hospital?

1. ASterile technique, with a sterile catheter and sterile glove
2. BClean technique, reusing the catheter during the shift
3. CClean technique, with the catheter rinsed in tap water
4. DNo gloves at all, because the airway already contains bacteria

Victims of a chemical spill arrive at the emergency department with liquid on their skin and clothing. What is the priority before they enter the building?

1. ATake them straight into the resuscitation room so treatment is not delayed
2. BTake a full history in the waiting room
3. CDecontaminate them outside, with staff wearing appropriate PPE
4. DGive them hospital gowns and seat them in triage

An older adult with chronic kidney disease starts trimethoprim-sulfamethoxazole for a urinary tract infection. Which electrolyte should be monitored closely?

1. ASodium, because the drug causes heavy sodium retention
2. BPotassium, because trimethoprim can raise it
3. CChloride, because the drug causes chloride loss
4. DCalcium, because the drug binds calcium in the gut

A woman who is 34 weeks pregnant has high blood pressure, right upper abdominal pain, a platelet count of 70 × 10³/µL, raised ALT and AST, and a raised LDH. Which condition fits best?

1. APhysiologic anemia of pregnancy
2. BGestational diabetes
3. CAcute cholecystitis
4. DHELLP syndrome

A patient is prescribed two different eye drops at the same time. What is correct?

1. AWait about five minutes between the two drops
2. BMix the two drops in one bottle
3. CGive both drops at once into the same eye
4. DGive one drop now and the other the next day

A patient with suspected appendicitis says the pain suddenly eased, but an hour later has pain all over the abdomen, a rigid abdomen and a fever. What is most likely?

1. AThe appendicitis has resolved without treatment
2. BThe appendix has perforated, causing peritonitis
3. CThe analgesia has started working
4. DThe patient has developed gastroenteritis

A patient's ankle–brachial pressure index (ABPI) is 0,6. What does this suggest?

1. AStiff, calcified arteries that read falsely high
2. BA deep vein thrombosis
3. CSignificant peripheral arterial disease
4. DNormal leg circulation

Minutes after an IV antibiotic is started, a patient has wheeze, swollen lips, a rash and BP 78/44 mmHg. The infusion has been stopped and help called. What is the next priority?

1. ARestart the infusion at a slower rate
2. BGive a nebulised salbutamol dose only
3. CGive an oral antihistamine tablet and observe for an hour
4. DGive intramuscular adrenaline (epinephrine)

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

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

A patient with suspected meningitis has a GCS of 9 and pupils that have become unequal. A doctor plans an immediate lumbar puncture. What is the main concern?

1. ARaised pressure in the skull, so the procedure could cause herniation
2. BThere is no concern, because the lumbar puncture lowers pressure safely
3. CA lumbar puncture would spread the infection to the blood
4. DThe patient is too confused to stay still, so it is not needed

What is achalasia?

1. AFailure of the lower oesophageal sphincter to relax on swallowing
2. BWeakness of the lower oesophageal sphincter that allows reflux
3. CA tear at the junction of the oesophagus and the stomach
4. DInflammation of the oesophagus caused by a fungal infection

Một bệnh nhân mở thông hồi tràng không có dịch thải trong 6 giờ, kèm đau quặn, chướng bụng, buồn nôn và stoma sưng. Điều dưỡng nên nghi ngờ gì?

1. APhát ban da nhẹ quanh stoma
2. BMất nước do dịch thải hồi tràng rất cao
3. CTắc stoma, thường do thức ăn, cần đánh giá
4. DGiai đoạn yên lặng bình thường của mở thông hồi tràng mới