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

Người bệnh nào phù hợp nhất để phân công cho LPN/LVN?

1. ANgười bệnh suy tim mạn ổn định cần thuốc đường uống
2. BNgười bệnh sắp nhận đơn vị hồng cầu đầu tiên
3. CNgười bệnh từ phòng hồi tỉnh đến cần đánh giá ban đầu
4. DNgười bệnh nhập viện 30 phút trước với đau ngực mới

Several patients on a unit develop diarrhea within two days. What should the nurse do first?

1. AGive all patients antidiarrheal drugs without assessment
2. BMove the affected patients into shared rooms with other patients to free up beds
3. CPlace affected patients on contact precautions and inform infection control
4. DWait to see if more patients become unwell

A patient with a respiratory infection has a raised procalcitonin level. What does this most suggest?

1. AA purely viral illness
2. BA bacterial rather than a viral infection
3. CAn allergic reaction to a recent medication
4. DDehydration from poor intake

A nurse teaches a patient about care of a surgical incision at home. Which statement shows a need for further teaching?

1. A“I will keep the dressing clean and dry as I was shown.”
2. B“I will call the clinic if I get a fever or more pain around the wound.”
3. C“If the wound gets red and drains pus, I will wait for my appointment next month.”
4. D“I will wash my hands with soap before I touch or change the dressing.”

A patient takes high-dose biotin supplements for hair and nails. Why should the nurse report this before blood tests?

1. ABiotin lowers the hemoglobin by destroying the red cells
2. BBiotin causes a true rise in blood glucose in all patients
3. CBiotin makes the blood clot in the tube before testing
4. DBiotin can distort some immunoassays, such as troponin or TSH

A patient has a positive hepatitis C antibody (anti-HCV) test. What is the most appropriate next step?

1. ARepeat the antibody test, as a positive test is always false
2. BGive hepatitis C vaccine to prevent further infection
3. CTest for HCV RNA to find out whether infection is current
4. DTell the patient they definitely have chronic hepatitis C

A patient on the ward has shingles with open blisters. Which people are most at risk from contact?

1. AOnly people over 80 who have already had shingles themselves
2. BNo one, because shingles cannot spread
3. CPeople who have already had chickenpox in childhood and are now healthy
4. DPregnant women and immunocompromised people who have not had chickenpox

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

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

Một bệnh nhân đau ngực giữa và có STEMI trên điện tâm đồ. Điều này thường đòi hỏi gì?

1. AThuốc chẹn beta đường uống và cho về nếu hết đau
2. BCó kết quả troponin trước khi đưa ra bất kỳ quyết định điều trị nào
3. CNhập viện và làm lại điện tâm đồ vào sáng hôm sau
4. DTái tưới máu cấp cứu, ưu tiên can thiệp mạch vành qua da thì đầu (primary PCI)

A patient with infective endocarditis is on IV gentamicin with another antibiotic. Which monitoring is most important?

1. ALiver size by daily palpation and weekly abdominal ultrasound
2. BBlood glucose only
3. CPeak flow readings and spirometry before and after each dose
4. DDrug levels, renal function and hearing or balance changes

Which headache feature most suggests raised intracranial pressure from a brain tumour?

1. AWorse on waking and on coughing, with vomiting
2. BBetter in the morning and worse with stress
3. COnly present after reading for a long time
4. DA tight band across the forehead that eases with rest

A prescription reads "Insulin 10U". Why is this a safety problem?

1. AThere is no problem as long as the nurse can read it
2. B"U" can be misread as a zero, giving a tenfold dose
3. CInsulin doses must always be written in millilitres
4. D"U" means the insulin must be given intravenously

How should a patient use an incentive spirometer after surgery?

1. AUse it once a day, just before going to sleep at night
2. BBlow out as hard and as fast as possible
3. CBreathe quickly in and out ten times in a row
4. DBreathe in slowly and deeply, then hold briefly

A sacral wound has heavy exudate, and the surrounding skin is white, soft and wrinkled. What should the nurse do?

1. AApply a tight plastic film directly over the wound
2. BUse a dressing that adds even more moisture
3. CLeave the same dressing in place for a week so the wound is not disturbed
4. DProtect the skin edges and use a more absorbent dressing