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

Một người bệnh đột ngột chảy máu cam, tỉnh táo và thở bình thường. Điều dưỡng làm gì trước tiên?

1. ABảo người bệnh xì mũi mạnh để loại cục máu
2. BCho người bệnh nằm ngửa phẳng với gối dưới đầu gối
3. CNgửa đầu ra sau và chườm đá vào gáy
4. DCho người bệnh ngồi dậy, cúi người về phía trước và bóp phần mềm của mũi

A patient with diabetes is sweaty and confused, and no glucose meter is available. The patient can swallow. What should the nurse do?

1. AAsk the patient to lie down and sleep it off
2. BGive a dose of rapid-acting insulin in case the glucose is high
3. CWithhold all food and fluids until a meter is found
4. DTreat for hypoglycemia with fast-acting oral carbohydrate

A patient cannot bear weight and cannot help with transfers. Which method is safest to move the patient from bed to chair?

1. AA mechanical lift used by enough trained staff
2. BAsking the patient to stand and try their best
3. CTwo nurses lifting the patient under the arms
4. DOne nurse doing a standing pivot transfer

A patient sitting in a chair starts to have a generalized seizure. What should the nurse do?

1. AEase the patient to the floor, protect the head and turn them on their side
2. BHold the patient firmly in the chair until the seizure stops
3. CLeave to get the provider, then return
4. DPut a padded tongue blade between the teeth to protect the tongue and airway

A patient without symptoms has a fasting plasma glucose of 132 mg/dL (7,3 mmol/L) on Monday and 138 mg/dL (7,7 mmol/L) on Thursday. What does this show?

1. AThe results meet the criteria for diabetes
2. BThe results show prediabetes only
3. CThe results show reactive hypoglycemia
4. DThe results are within the normal fasting range

Two weeks after a sore throat, a child develops dark (cola-colored) urine, puffy eyes and high blood pressure. Urinalysis shows red cell casts and protein. Which condition is most likely?

1. ALower urinary tract infection (cystitis)
2. BPost-streptococcal glomerulonephritis
3. CKidney stone in the ureter
4. DPrerenal acute kidney injury

A patient on insulin reports nightmares, night sweats and morning headaches. What should be suspected?

1. ANight-time hypoglycaemia
2. BRaised intracranial pressure
3. CHyperthyroidism
4. DA urinary tract infection

A patient with a confirmed pulmonary embolism is started on anticoagulation. Which statement best explains its purpose?

1. AIt stops the clot growing and prevents new clots while the body breaks it down
2. BIt is mainly given to lower the blood pressure
3. CIt thins the blood so that the lungs absorb more oxygen
4. DIt dissolves the clot completely within minutes of the first dose being given

After an above-knee amputation, which measure helps prevent a hip flexion contracture?

1. ASitting in a chair for most of the day with the hips bent
2. BKeeping the hip bent to reduce stump swelling
3. CLying prone for periods and avoiding pillows under the stump
4. DKeeping a pillow under the stump at all times, day and night

A patient with end-stage COPD has severe breathlessness at rest despite optimal treatment and wants comfort-focused care. Which measure is recognised to help?

1. AHigh-flow oxygen at 15 L/min whatever the oxygen saturation is
2. BStopping all medicines, including inhalers
3. CEncouraging long walks to build fitness
4. DA low-dose opioid with a hand-held fan and calm positioning

An 85-year-old care home resident becomes newly confused and is falling more often. A UTI is one possibility. Why?

1. AA UTI cannot occur in people over 80
2. BOlder adults often show infection as confusion
3. CConfusion is the only symptom of a UTI at any age
4. DUrinary infections always cause a high fever in older adults

An older patient with a UTI is now confused, with a respiratory rate of 24/min, BP 88/50 mmHg and a pulse of 120/min. What should happen?

1. AGive oral antibiotics and recheck in four hours
2. BTreat the confusion with a sedative
3. CStart sepsis care at once, with IV antibiotics and fluids
4. DEncourage oral fluids and wait for the urine culture

Dysphagia that started with solids and now includes liquids, with weight loss, most suggests which cause?

1. AA narrowing such as an oesophageal tumour
2. BNormal ageing of the swallowing muscles
3. CSimple anxiety about swallowing tablets
4. DA dry mouth from drinking too little water

After signing the consent form, a patient tells the nurse, "I don't really understand what they are going to do." What should the nurse do?

1. AIgnore the comment because the form is already signed
2. BExplain the surgical risks in detail without involving the surgeon
3. CInform the surgeon so that the procedure can be explained again
4. DReassure the patient that the surgeon knows best