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

A patient is receiving opioids after surgery. Which finding usually comes before opioid-induced respiratory depression?

1. AIncreased appetite and thirst
2. BA rise in blood pressure with flushed cheeks
3. CA sudden rise in pain scores
4. DIncreasing sleepiness that is hard to rouse

The charge nurse overhears four instructions from an RN to a nursing assistant. Which one needs to be corrected?

1. A“Check his glucose and give the insulin according to the sliding scale.”
2. B“Help him wash and change, and tell me at once if you see any red or broken skin.”
3. C“Walk him to the bathroom and back, and stay with him the whole time.”
4. D“Check his glucose before lunch and tell me the number straight away.”

A small spill of blood is found on the floor. How should it be cleaned?

1. AWear gloves, absorb the blood, then clean the area with an approved disinfectant
2. BLeave it until housekeeping arrives the next morning
3. CWipe it up quickly with a dry cloth using bare hands, then wash the hands well
4. DCover it with a clean sheet and keep working

A nurse teaches new parents about safe infant sleep. Which statement shows a need for further teaching?

1. A“We will keep the crib in our room, next to our bed, for the first months.”
2. B“We will not smoke near the baby.”
3. C“We will lay the baby on the back for every sleep, including naps.”
4. D“We will put a soft bumper pad and a blanket in the crib so the baby is cozy.”

Hemoglobin của một người bệnh là 7,8 g/dL (78 g/L). Điều dưỡng mong đợi những phát hiện nào?

1. AMệt mỏi, xanh xao, nhịp tim nhanh và khó thở khi gắng sức
2. BNhịp tim chậm, da đỏ bừng và huyết áp cao
3. CĐau đầu, chảy máu cam và mặt đỏ
4. DNgứa, da vàng và nước tiểu sẫm màu

A patient with severe sepsis is oozing blood from IV sites. Platelets 40 × 10³/µL, fibrinogen low, D-dimer very high, PT and aPTT both prolonged. Which condition fits best?

1. ADisseminated intravascular coagulation (DIC)
2. BImmune thrombocytopenic purpura (ITP)
3. CHemophilia A (factor VIII deficiency)
4. DHeparin-induced thrombocytopenia (HIT)

A patient has a fentanyl patch for chronic pain. Which advice is correct?

1. AApply the patch to broken skin for faster effect
2. BKeep using the old patch with the new one
3. CAvoid heat sources such as hot water bottles over the patch
4. DCut the patch in half if the pain improves, to lower the dose

A patient took a large paracetamol (acetaminophen) overdose six hours ago and says they feel well. Why is treatment still urgent?

1. APatients who feel well after six hours never need any treatment at all
2. BLiver damage develops later, and the antidote works best when given early
3. CParacetamol damage only shows up in the kidneys, many weeks later
4. DParacetamol overdose causes immediate breathing problems

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

1. AAn immediate unsynchronised shock with the defibrillator
2. BA large oral dose of digoxin
3. CVagal manoeuvres such as a modified Valsalva
4. DChest compressions until the rate slows

A patient who has had a total laryngectomy becomes breathless and needs oxygen. How should it be given?

1. AVia a standard face mask over the nose and mouth
2. BVia a mask or humidified device over the neck stoma
3. CVia nasal cannula at 2 L/min
4. DVia a non-rebreather mask over the mouth only

Which complication is a particular risk in nephrotic syndrome?

1. ABleeding from low platelets
2. BHypoglycaemia
3. CVenous thrombosis
4. DLow cholesterol

Lúc 03:00 đường huyết của bệnh nhân là 3,6 mmol/L, nhưng trước bữa sáng thì cao. Họ tiêm insulin tác dụng kéo dài vào buổi tối. Điều dưỡng nên làm gì?

1. ABỏ qua kết quả ban đêm và chỉ xử trí theo giá trị buổi sáng
2. BNgừng mọi insulin vĩnh viễn và theo dõi đường huyết mỗi bốn giờ
3. CĐiều trị đường huyết thấp và báo kiểu hình này để xem lại liều buổi tối
4. DCho thêm insulin lúc 03:00 vì giá trị buổi sáng sẽ cao

Which group of findings suggests obstruction of the bile duct?

1. ARed urine, black stools and a high blood glucose
2. BJaundice, dark urine, pale stools and itching
3. CNormal skin colour with diarrhoea and fever
4. DPale urine, dark stools and a flapping tremor

A patient finds daily wound dressing changes very painful. What is the most effective nursing approach?

1. ADo the dressing quickly and give analgesia afterwards
2. BChange the dressing less often than the plan says
3. CAvoid analgesia so the patient can report any problems during the change
4. DGive analgesia timed so it works during the dressing change