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

Which patient is at the highest risk of falling?

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

A patient is bleeding internally after a fall. Which finding is usually an early sign of hypovolemic shock?

1. ARestlessness and a rising heart rate while the blood pressure is still normal
2. BA slow heart rate with warm, dry, flushed skin and a normal blood pressure throughout
3. CA very low blood pressure with fixed, dilated pupils
4. DLoss of consciousness with gasping breaths

A nurse wants to set up a sterile field in the morning for a procedure that will take place after lunch. What is correct?

1. ASet it up just before the procedure, because a waiting field may become contaminated
2. BSet it up in the morning and cover it with a clean towel until the procedure starts
3. CSet it up in the morning and leave it uncovered in an empty room
4. DSet it up in the morning and ask a colleague to check it once

A patient on long-term high-dose corticosteroids asks for the nasal spray influenza vaccine. What should the nurse explain?

1. AThe nasal spray is the best choice for people on steroids, because it is not injected
2. BEither type is fine, as long as it is given in the morning
3. CPeople on steroids should never have any influenza vaccine
4. DThe nasal spray is a live vaccine, so the injected inactivated vaccine is used instead

A patient with chronic kidney disease receives an erythropoiesis-stimulating agent such as epoetin alfa. Which assessments are most important?

1. ASerum amylase and lipase
2. BHemoglobin and blood pressure
3. CLiver enzymes and bilirubin
4. DSerum glucose and ketones

A 5-year-old has new bruising and petechiae two weeks after a viral illness. Platelets are 12 × 10³/µL; hemoglobin, white cell count and clotting times are normal. Which condition is most likely?

1. AAcute leukemia
2. BImmune thrombocytopenia (ITP)
3. CHemophilia A
4. DDisseminated intravascular coagulation

Which of these is a non-drug measure that can help relieve pain?

1. ARepositioning and distraction
2. BKeeping the patient awake all night
3. CTelling the patient that the pain is not real
4. DRestricting visitors completely

A patient suddenly develops a painful red eye with blurred vision, haloes around lights and vomiting. What should be suspected?

1. AA stye
2. BDry eye syndrome
3. CSimple conjunctivitis from a viral infection
4. DAcute angle-closure glaucoma

What is the main problem in heart failure with preserved ejection fraction?

1. AA blocked pulmonary artery
2. BA stiff ventricle that fills poorly in diastole
3. CA leaking aortic valve
4. DA dilated ventricle that cannot contract strongly

A 70-year-old man has a small abdominal aortic aneurysm found on screening and is placed under surveillance. Which advice is most important?

1. AStop smoking, control BP and seek help at once for sudden back pain
2. BAvoid all exercise and lifting for the rest of his life to protect the aorta
3. CStop all blood pressure medicines to avoid low pressure
4. DHave the aneurysm repaired immediately, whatever its size or growth rate

How does bladder training help urge incontinence?

1. AA catheter is used every night
2. BThe patient drinks as little as possible
3. CThe time between voids is slowly increased
4. DThe patient goes to the toilet every 15 minutes

A patient with acromegaly snores loudly, stops breathing at times in sleep and is sleepy during the day. What is most likely?

1. ANormal snoring
2. BNarcolepsy
3. CObstructive sleep apnoea
4. DAn anxiety disorder

Why should metoclopramide not be used for nausea in mechanical bowel obstruction?

1. AIt increases gut movement against the blockage
2. BIt makes the bowel stop moving completely
3. CIt always causes severe diarrhoea
4. DIt blocks the effect of all opioids

On the ward after surgery, a patient has a red, blistered area of skin under where the diathermy plate was. What should the nurse do?

1. ATreat it as a possible burn, report it and complete an incident form
2. BWash it with alcohol and leave it uncovered
3. CIgnore it because skin changes after surgery are normal and expected to fade
4. DApply a hot water bottle to improve the circulation