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

A patient on a continuous IV heparin infusion has new black, tarry stools and an aPTT well above the target range. What should the nurse do first?

1. ACheck the pump rate and leave the infusion running
2. BGive a dose of vitamin K by mouth
3. COffer an iron-rich meal to replace the lost blood
4. DStop the heparin infusion and inform the provider

Two days after starting haloperidol, a patient suddenly develops painful neck twisting and the eyes roll upwards. What should the nurse anticipate?

1. AA higher dose of haloperidol to calm the patient and stop the movements quickly
2. BAn anticholinergic drug, such as benztropine or procyclidine, as prescribed
3. CPhysical restraint until the spasm passes
4. DNo action, because the spasm is a sign of improvement

Hai bệnh nhân có tên rất giống nhau ở cùng một khoa. Biện pháp an toàn nào tốt nhất?

1. AChỉ gọi mỗi bệnh nhân bằng tên riêng
2. BDùng số phòng để phân biệt các bệnh nhân
3. CChuyển một trong hai bệnh nhân sang bệnh viện khác
4. DGắn cờ cảnh báo tên giống nhau và kiểm tra hai yếu tố nhận dạng mỗi lần

A patient after heart surgery has temporary epicardial pacing wires. Why do staff take special care with electrical safety?

1. AThe wires make the patient immune to electric shock
2. BElectrical safety only matters for patients who have permanent implanted pacemakers
3. CPacing wires can only carry current coming from the pacemaker box itself
4. DSmall currents can travel along the wires straight to the heart and cause arrhythmias

A patient's potassium is 7,0 mEq/L. Which ECG change would the nurse expect?

1. AFlattened T waves
2. BProminent U waves
3. CDelta waves before the QRS
4. DTall, peaked T waves

A patient has marked generalized edema. Results show heavy proteinuria, serum albumin 1,8 g/dL (18 g/L) and total cholesterol 340 mg/dL (8,8 mmol/L). Which condition fits best?

1. ALiver cirrhosis only
2. BPrerenal kidney injury
3. CAcute pyelonephritis
4. DNephrotic syndrome

For a patient in skin traction on the leg, which is correct?

1. AThe weights rest on the floor overnight
2. BThe rope is tied to the bed frame to keep it still
3. CThe weights are removed whenever the patient feels uncomfortable
4. DThe weights hang freely and do not rest on the bed or floor

A patient with poorly controlled hyperthyroidism develops a high fever, very fast heart rate, agitation and vomiting during an infection. What is likely?

1. AHypoglycaemia
2. BThyroid storm
3. CMyxoedema coma
4. DAddisonian crisis

A patient has pneumonia in the right lung only. In which side-lying position will oxygenation usually be best?

1. AProne with the head down
2. BFlat on the back with no pillows
3. CLying on the right side, with the affected lung down
4. DLying on the left side, with the healthy lung down

A 74-year-old with atrial fibrillation, hypertension and diabetes asks why she needs an anticoagulant when she feels well. Which reply is best?

1. AHer risk of stroke is high, and an anticoagulant lowers it
2. BIt is needed only while she has palpitations
3. CIt is given to lower her blood pressure
4. DThe anticoagulant will stop the irregular heartbeat for good

Which side effects are common with oxybutynin for an overactive bladder?

1. ADry mouth and constipation
2. BWeight loss and a fast tremor
3. CDiarrhoea and heavy sweating
4. DA cough and a raised potassium

The nurse has four patients. Which one needs to be seen first?

1. AA patient with stable CKD waiting for a renal diet review
2. BA patient with hypothyroidism asking when to take levothyroxine
3. CA patient with Parkinson's disease whose next dose is due in two hours
4. DA patient on insulin for DKA whose potassium is now 2,9 mmol/L

Vì sao bệnh nhân xơ gan có nguy cơ chảy máu tăng?

1. AGan xơ giải phóng các chất chống đông như heparin vào máu
2. BÍt yếu tố đông máu hơn, tiểu cầu thấp và giãn tĩnh mạch do tăng áp lực tĩnh mạch cửa
3. CHuyết áp động mạch cao trong xơ gan làm mạch vỡ
4. DXơ gan làm tăng số lượng tiểu cầu, khiến tiểu cầu yếu hơn

A patient admitted for an elective general anaesthetic mentions that they ate a slice of toast 3 hours ago. What should the nurse do?

1. ASay nothing, since toast is a light food
2. BInform the anaesthetist, as surgery may be delayed
3. CGive a large drink to wash the food through
4. DAsk the patient to try to vomit to empty the stomach