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

A patient with type 1 diabetes has vomited since morning and cannot eat. Which action is most important?

1. AStop all insulin until the patient is able to eat normally again
2. BCheck the blood glucose and ketones and contact the provider
3. CWait until tomorrow to see if the vomiting settles
4. DEncourage a large meal to settle the stomach

A patient suddenly has severe pain in one leg. The leg is pale and cold with no pedal pulse. What does this suggest?

1. AA muscle cramp that will pass with stretching
2. BA deep vein thrombosis that can be treated next week
3. CAcute arterial occlusion, which is an emergency
4. DChronic venous insufficiency that needs elevation

Which IV fluid can be given with packed red blood cells in the same line?

1. ALactated Ringer’s (Hartmann’s) solution
2. B5% dextrose in 0,45% sodium chloride
3. C0,9% sodium chloride
4. D5% dextrose in water

A nurse teaches a patient about care of a surgical incision at home. Which statement shows a need for further teaching?

1. A“If the wound gets red and drains pus, I will wait for my appointment next month.”
2. B“I will keep the dressing clean and dry as I was shown.”
3. C“I will wash my hands with soap before I touch or change the dressing.”
4. D“I will call the clinic if I get a fever or more pain around the wound.”

A patient with diabetes also takes propranolol. Why is regular glucose monitoring especially important?

1. AThe drug causes very high glucose in all patients
2. BThe drug can mask warning signs of hypoglycemia
3. CThe drug blocks the insulin injection site
4. DThe drug stops the meter from reading correctly

Mẫu kết quả nào phù hợp với SIADH?

1. ANatri huyết thanh cao, độ thẩm thấu huyết thanh cao và nước tiểu rất loãng
2. BNatri bình thường với nước tiểu rất loãng
3. CNatri huyết thanh thấp, độ thẩm thấu huyết thanh cao và nước tiểu loãng
4. DNatri huyết thanh thấp, độ thẩm thấu huyết thanh thấp và nước tiểu cô đặc

After a laparoscopic cholecystectomy, a patient has pain in the shoulder tip. What is the most likely cause?

1. AA heart attack caused by the stress of surgery
2. BAn allergic reaction to the dressing
3. CGas used during the operation irritating the diaphragm
4. DA broken collarbone from being moved onto the table

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

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

A patient on nasal cannula oxygen breathes mainly through the mouth. What is the most accurate statement?

1. AIt can still work, because oxygen collects in the nasopharynx
2. BThe flow must be increased to 15 L/min to make it work at all
3. CThe cannula should be placed in the mouth
4. DIt has no effect at all in mouth breathers and must be stopped

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

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

Bệnh nhân dùng phenytoin dài hạn nên được dặn về tác dụng phụ nào?

1. ARụng tóc ở da đầu ở gần như mọi bệnh nhân
2. BPhì đại nướu, nên vệ sinh răng miệng tốt rất quan trọng
3. CSụt cân và không chịu nóng
4. DMất thính lực dần dần, vĩnh viễn

Two days after surgery, an 80-year-old woman is quiet, sleepy, slow to answer and eating little. Her daughter says she is "not herself". What should the nurse suspect?

1. AThe start of Alzheimer's disease
2. BNormal tiredness after an operation
3. CHypoactive delirium
4. DSimple low mood about being in hospital

Why is IV hydration given with cisplatin?

1. ATo raise the blood pressure during treatment
2. BTo make the drug less effective
3. CTo protect the kidneys from damage
4. DTo prevent hair loss

On the morning of elective hip surgery, a patient says she took her usual warfarin last night despite being told to stop. What should the nurse do?

1. AInform the surgical and anaesthetic teams, who will check the INR
2. BProceed with the usual checklist and say nothing
3. CTell her the surgery must be cancelled for a month
4. DGive a double dose of vitamin K by mouth without waiting for a prescription