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

A nursing assistant tells the RN that a patient’s IV pump is alarming. What is the best response?

1. A“Turn the pump off and on again until it stops.”
2. B“I will come and check the pump and the IV site now.”
3. C“Silence the alarm and I will check it at the end of the shift.”
4. D“Increase the rate a little so the alarm clears.”

A patient with COPD on 2 L/min oxygen becomes drowsy and hard to wake. The SpO₂ is 93%. What is the priority?

1. AIncrease the oxygen to 6 L/min so that the saturation goes even higher than now
2. BLet the patient sleep, because the saturation is above target
3. CAssess breathing and escalate for a blood gas, as carbon dioxide may be rising
4. DGive the as-needed sedative so the patient rests comfortably

Which practice is safe when transferring a patient from a bed to a stretcher?

1. ALock the wheels of both the bed and the stretcher before moving the patient
2. BLeave the stretcher wheels unlocked so it can move with the patient
3. CHave the patient slide across without help or a slide sheet
4. DLower the stretcher side rails during transport

Which patient with a suspected infection meets the qSOFA criteria that signal a higher risk of a poor outcome?

1. ARespiratory rate 24/min, new confusion, systolic BP 95 mmHg
2. BRespiratory rate 18/min, alert, systolic BP 130 mmHg, temperature 38,5 °C
3. CRespiratory rate 20/min, alert, systolic BP 110 mmHg, heart rate 110/min
4. DRespiratory rate 16/min, alert, systolic BP 105 mmHg, WBC 13,000/mm³

A patient's potassium is unexpectedly 5,8 mEq/L. The sample was taken after the tourniquet was on for several minutes while the patient pumped their fist. What is the best interpretation?

1. AThe result may be falsely high and should be repeated with better technique
2. BFist pumping lowers potassium, so the true level is even higher
3. CThe result confirms true hyperkalemia and needs no further checking
4. DTourniquet time affects only the glucose result, not the potassium

A patient with suspected Cushing syndrome takes dexamethasone at night. The next morning, the cortisol is still high. What does this suggest?

1. AThe result is normal, as dexamethasone raises cortisol
2. BCortisol is being produced without normal feedback control
3. CThe patient has primary hypothyroidism instead
4. DThe adrenal glands are not able to produce enough cortisol

After a needlestick injury from a patient known to have HIV, why must the nurse report it immediately?

1. AThe needle must be sent for culture
2. BThe nurse must be tested for HIV the same day to confirm infection
3. CPost-exposure prophylaxis works best when started as soon as possible
4. DThe patient will need antibiotics

Why should chronic hypernatraemia be corrected gradually?

1. AFast correction causes osmotic demyelination from swelling of the kidneys
2. BLowering the sodium too fast can cause cerebral oedema
3. CFast correction causes severe hyperkalaemia
4. DSlow correction is only needed in children

How big should a suction catheter be compared with the tracheostomy or endotracheal tube?

1. ALarger than the tube, so that it clears it completely
2. BNo more than half the internal diameter of the tube
3. CExactly the same diameter as the tube, for a tight fit
4. DAny size, as the diameter does not matter

After four days of antibiotics for pneumonia, a patient still has fever and pleuritic pain. There is dullness and reduced breath sounds at the right base. What complication should be suspected?

1. AAn allergic reaction to the antibiotic
2. BAsthma triggered by the infection
3. CA parapneumonic effusion or empyema
4. DNormal recovery from pneumonia

Sau phẫu thuật tuyến yên, bệnh nhân đi tiểu 400 mL mỗi giờ trong ba giờ với tỷ trọng thấp. Điều dưỡng nên nghi ngờ điều gì?

1. AĐái tháo nhạt
2. BTổn thương thận cấp
3. CLợi niệu bình thường
4. DSIADH

A patient on a variable rate IV insulin infusion is nil by mouth. Why is a glucose-containing IV fluid usually given alongside it?

1. ATo stop the insulin sticking to the IV tubing
2. BTo replace the potassium lost from the cells
3. CTo speed up the action of the insulin in the muscles
4. DTo prevent hypoglycaemia while insulin is running

Why are many patients screened for MRSA before planned surgery?

1. ATo decide which anaesthetic drug to use
2. BSo that carriers can be decolonised to reduce infection
3. CSo that surgery can be cancelled for all positive patients
4. DTo check whether the patient has had a flu vaccine

Một bệnh nhân tắc ruột xuất hiện đau liên tục dữ dội (không còn từng cơn), sốt, nhịp tim 120/phút và bụng cứng, đau. Điều này gợi ý gì?

1. ATắc nghẽn đang giải quyết khi ruột bắt đầu cử động
2. BNghẹt ruột hoặc thủng cần phẫu thuật viên đánh giá khẩn
3. CDiễn tiến bình thường chỉ cần giảm đau đơn giản đều đặn
4. DTáo bón nên điều trị bằng thuốc nhuận tràng kích thích