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

The day after a total thyroidectomy, a patient reports tingling around the mouth and in the fingers. What should the nurse do first?

1. AReassure the patient that this is normal after neck surgery
2. BEncourage deep breaths into a paper bag until it passes
3. CGive the patient’s routine oral iron supplement early
4. DCheck for signs of low calcium and inform the provider

A patient receiving comfort-focused end-of-life care is distressed by breathlessness. Which approach is most appropriate?

1. AWithhold all opioids because they may slow breathing
2. BLeave the patient alone so they can rest
3. CGive prescribed opioids and use positioning and a fan to relieve breathlessness
4. DStart a series of aggressive tests to find the exact cause of the breathlessness

A patient is booked for an MRI scan. What must the nurse check beforehand?

1. AWhether the patient’s blood glucose has been in the normal range today
2. BWhether the patient has had a hearing test this year
3. CWhether the patient has eaten a large meal recently
4. DWhether the patient has any metal implants or devices, such as a pacemaker

Which patient with a suspected infection meets at least two SIRS criteria?

1. ARespiratory rate 16/min and WBC 8,000/mm³
2. BTemperature 38,6 °C and heart rate 112/min
3. CTemperature 37,2 °C and heart rate 80/min
4. DTemperature 36,8 °C and respiratory rate 18/min

A urine culture report states "mixed growth of three organisms, likely contamination." What is the nurse's best response?

1. AStart treatment for all three organisms with three antibiotics
2. BInform the provider and arrange a new, correctly collected sample
3. CRecord the result as a confirmed urinary tract infection
4. DDiscard the report, because a mixed growth is always normal

Three days after starting haloperidol, a patient has a temperature of 40 °C, severe muscle rigidity and confusion. Which laboratory result would the nurse expect?

1. AA very high creatine kinase (CK)
2. BA very low white cell count
3. CA very low serum sodium
4. DA very high serum lithium

Bệnh nhân bắt đầu dùng thuốc ức chế men chuyển (ACE inhibitor) bị ho khan dai dẳng. Nguyên nhân có khả năng là gì?

1. AThuyên tắc phổi
2. BTác dụng phụ đã được ghi nhận của thuốc ức chế men chuyển
3. CHen do thuốc chẹn beta
4. DPhản ứng dị ứng với penicillin vừa được dùng

A patient with central chest pain has ST elevation on the 12-lead ECG. What is the main aim of urgent treatment?

1. ARestoring blood flow through the blocked coronary artery quickly
2. BStarting a cholesterol-lowering drug before any other treatment is given
3. CStrict bed rest for several days before deciding on treatment
4. DWaiting for the troponin result before taking any action

The telemetry monitor suddenly shows a chaotic waveform resembling ventricular fibrillation, but the patient is talking and brushing their teeth. What should the nurse do first?

1. ADeliver an immediate defibrillation shock before checking anything
2. BGive IV amiodarone as a bolus
3. CStart chest compressions straight away and call the arrest team
4. DCheck the patient and the electrodes, as this is likely artefact

A heavy smoker is having surgery tomorrow and asks whether stopping smoking now is pointless. Which reply is most accurate?

1. AStopping now will make the operation more dangerous
2. BIt is pointless unless they stopped smoking at least a year ago
3. CSmoking before surgery protects the lungs from the anaesthetic gases
4. DStopping even today lowers carbon monoxide levels before surgery

A patient with gout has recurrent uric acid kidney stones. Which treatment helps prevent them?

1. AVitamin C supplements and a high-meat diet
2. BCalcium tablets and a low-fluid diet
3. CRestricting fluids in the evening only
4. DAllopurinol and making the urine less acidic

After removal of a cortisol-producing adrenal adenoma, why may the patient need hydrocortisone for months?

1. AThe operation always removes both adrenal glands
2. BThe tumour will grow back quickly without it
3. CHydrocortisone helps the wound to heal
4. DThe other adrenal gland has been suppressed

Why do patients usually have a dental review before radiotherapy to the head and neck?

1. AIt causes dry mouth and raises the risk of decay and jaw damage
2. BThe dentist gives the radiotherapy
3. CRadiotherapy can only be given once all the teeth have been removed
4. DTeeth block the radiation beam completely

A nurse teaches a patient about a fentanyl skin patch. Which statement shows a need for further teaching?

1. A"I can cut the patch in half if I need less."
2. B"I'll put the new patch on a different area of skin."
3. C"I won't put a hot water bottle over the patch."
4. D"I'll fold used patches sticky sides together before disposal."