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

After a hip replacement using a posterior approach, which statement shows a need for further teaching?

1. A“I will use a raised toilet seat at home.”
2. B“I will keep a pillow between my knees when I lie on my side in bed.”
3. C“I will not bend my hip past 90 degrees.”
4. D“I will cross my legs when I sit, so I am more comfortable.”

A patient on a cardiac monitor suddenly becomes unresponsive, and the monitor shows ventricular fibrillation. What is the priority once help has been called?

1. ACheck the blood potassium level before any shock is considered
2. BDefibrillate as soon as the defibrillator is available, with CPR until then
3. CGive an oral antiarrhythmic tablet and recheck the rhythm in five minutes
4. DRecord a full 12-lead ECG to confirm the rhythm before doing anything else at all

Which practice reduces back strain when a nurse moves a patient or heavy object?

1. AStand with the feet close together for balance
2. BKeep the load close to the body and avoid twisting
3. CHold the load at arm’s length to keep it steady
4. DBend at the waist and keep both knees straight

A nursing student describes how they remove PPE (gown, gloves and a mask worn for splash protection) at the doorway before leaving a contact precautions room. Which statement shows a need for further teaching?

1. A“I clean my hands as soon as all the PPE is off.”
2. B“I roll the gown inward as I take it off.”
3. C“I take off my mask first, and then I take off my gloves.”
4. D“I remove my gloves without touching the outside with my bare hand.”

Một người bệnh đang truyền heparin có aPTT 110 giây; mục tiêu theo phác đồ là 1,5–2,5 lần chứng 30 giây. Điều dưỡng nên làm gì?

1. ATiếp tục không đổi và làm lại aPTT vào sáng hôm sau
2. BTăng tốc độ truyền, vì kết quả cao hơn khoảng mục tiêu
3. CTheo phác đồ heparin, kiểm tra chảy máu và báo cho người có thẩm quyền
4. DCho vitamin K theo y lệnh và tiếp tục truyền

A patient has eaten very little for 2 weeks and has received broad-spectrum antibiotics. The INR is now 2,3 without warfarin, and the platelets are normal. What is the most likely cause?

1. AImmune thrombocytopenia
2. BHemophilia A
3. CIron-deficiency anemia
4. DVitamin K deficiency

Bệnh nhân sau tai nạn giao thông khó thở nặng, mất tiếng thở ở một bên, huyết áp thấp và khí quản lệch sang bên kia. Chẩn đoán có khả năng là gì?

1. ATràn khí màng phổi áp lực
2. BHen
3. CViêm phổi
4. DPhù phổi

A nurse teaches a patient with a new ileostomy. Which statement shows a need for further teaching?

1. A"I will drink extra fluids when it is hot."
2. B"My output will be firm and formed like before."
3. C"I will empty the bag when it is about a third to half full."
4. D"My stoma should look pink or red and moist."

A patient with a regular narrow-complex tachycardia of 180/min is alert with a normal blood pressure. What is usually tried first?

1. AVagal manoeuvres such as a modified Valsalva
2. BChest compressions until the rate slows
3. CAn immediate unsynchronised shock with the defibrillator
4. DA large oral dose of digoxin

A patient with an inferior myocardial infarction develops complete heart block with a heart rate of 38/min. What is the most likely reason?

1. AThe right coronary artery usually supplies the AV node
2. BThe left anterior descending artery supplies the SA node only
3. CInferior infarcts always destroy the bundle of His permanently
4. DHeart block is caused by the thrombolytic drug

A patient taking warfarin is diagnosed with an intracerebral haemorrhage. What is the priority treatment?

1. AIV thrombolysis within 4,5 hours
2. BUrgent reversal of the anticoagulant effect
3. CStarting aspirin to prevent further clots
4. DDoubling the warfarin dose to stabilise the INR

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. CThe other adrenal gland has been suppressed
4. DHydrocortisone helps the wound to heal

Vì sao quan trọng khi bệnh nhân dùng opioid trở nên an thần hơn?

1. AAn thần nghĩa là nay cần liều cao hơn
2. BAn thần là tác dụng vô hại và dự kiến của mọi opioid
3. CAn thần nghĩa là cơn đau nay đã được kiểm soát hoàn toàn và an toàn
4. DAn thần tăng thường đi trước ức chế hô hấp

A patient has an implanted port for chemotherapy. Which needle is used to access it?

1. AAn intramuscular injection needle
2. BA wide-bore cannula with a steel stylet
3. CA standard hollow needle used for venepuncture
4. DA non-coring (Huber) needle