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

An older patient who has been constipated for days now has small amounts of liquid stool leaking. What should the nurse suspect?

1. AA new bowel infection that has caused the diarrhea
2. BFecal impaction with liquid stool passing around it
3. CA side effect of drinking too much water
4. DThe constipation has fully resolved

The charge nurse overhears four instructions from an RN to a nursing assistant. Which one needs to be corrected?

1. A“Walk him to the bathroom and back, and stay with him the whole time.”
2. B“Check his glucose before lunch and tell me the number straight away.”
3. C“Help him wash and change, and tell me at once if you see any red or broken skin.”
4. D“Check his glucose and give the insulin according to the sliding scale.”

A nurse gives part of a dose of an opioid from a vial and must discard the rest. What is correct?

1. ADiscard it in front of a second licensed (registered) nurse, who witnesses and documents it
2. BKeep the rest for the patient’s next dose
3. CDiscard it alone in the sink and document the amount wasted later in the shift
4. DReturn the rest to the patient’s medication drawer

A hospital will introduce new infusion pumps and wants to find out how the process could fail before any harm occurs. Which method fits best?

1. AFailure mode and effects analysis (FMEA)
2. BRoot cause analysis (RCA) of the new pumps
3. CA morbidity and mortality meeting
4. DAn incident report for each new pump

A patient with schizophrenia is starting clozapine. Which laboratory value must be monitored regularly?

1. AInternational normalized ratio
2. BSerum amylase
3. CSerum lithium level
4. DAbsolute neutrophil count

A patient has painless jaundice, itching, dark urine and pale stools. ALP is markedly raised, conjugated (direct) bilirubin is high and ALT is only mildly raised. What is the most likely cause?

1. ABlockage of bile flow, for example by a tumor in the bile duct
2. BGilbert syndrome, a harmless inherited bilirubin disorder
3. CAcute viral hepatitis with widespread liver cell damage
4. DIncreased breakdown of red blood cells (hemolytic anemia)

What should a nurse do during a generalised tonic-clonic seizure?

1. APut a tongue depressor between the teeth so that the tongue is not bitten
2. BProtect the head, time the seizure and do not put anything in the mouth
3. CHold the limbs firmly to stop the jerking and prevent injury
4. DGive the patient a drink of water

Bệnh nhân lớn tuổi gãy cổ xương đùi trở nên khó thở và lú lẫn, có phát ban chấm xuất huyết ở ngực hai ngày sau chấn thương. Cần nghĩ đến biến chứng nào?

1. ANhiễm trùng tiết niệu
2. BHội chứng thuyên tắc mỡ
3. CLoét tỳ đè
4. DHội chứng chèn ép khoang

Một bệnh nhân tăng huyết áp dùng amlodipine. Điều dưỡng nhiều khả năng quan sát thấy tác dụng phụ nào?

1. AHo khan, ngứa họng
2. BRan rít
3. CTăng kali máu
4. DPhù cổ chân

Một bệnh nhân dùng bisoprolol và diltiazem bị chóng mặt, nhịp tim 38/phút và huyết áp 82/50 mmHg. Phản ứng đầu tiên phù hợp nhất là gì?

1. AGhi các chỉ số và kiểm tra lại sau bốn giờ
2. BGọi hỗ trợ khẩn, đánh giá ABCDE và gắn monitor tim
3. CCho sớm các liều tiếp theo của cả hai thuốc để giữ nhịp tim ổn định
4. DCho bệnh nhân đi quanh khoa để tăng nhịp tim

A patient is starting lamotrigine. Which teaching point is most important?

1. ATake it with a glass of grapefruit juice to improve its absorption
2. BDouble the dose if a seizure happens
3. CExpect an orange tint to tears and urine
4. DReport any skin rash promptly, especially in the first weeks

Hai ngày sau chấn thương tủy sống C5, bệnh nhân lo lắng, nhịp thở 30/phút và dung tích sống giảm dần. Điều dưỡng nên làm gì?

1. ACho bệnh nhân nằm phẳng, ngửa đầu để mở đường thở
2. BCho thuốc an thần để làm chậm nhịp thở và giảm lo lắng
3. CBáo động khẩn: phù tủy có thể gây suy hô hấp
4. DKiểm tra lại dung tích sống sau khoảng 12 giờ

Which diet is usually recommended for a patient with cirrhosis and hepatic encephalopathy?

1. ANo food at all until the confusion settles
2. BNormal protein and enough calories, with a late-evening snack
3. COnly clear fluids for several weeks
4. DA very low-protein diet for the rest of their life to lower ammonia

Just after extubation in recovery, a patient develops a high-pitched noise on breathing in, with falling SpO₂. What should the nurse do first?

1. AGive an opioid to calm the patient's breathing and reduce anxiety
2. BWait a few minutes to see if it passes
3. CCall for help, give 100% oxygen and use a jaw thrust
4. DSit the patient up and give a drink of water