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

An arterial blood gas shows pH 7,28, PaCO₂ 40 mmHg (5,3 kPa) and HCO₃⁻ 16 mEq/L (mmol/L). How should the nurse interpret it?

1. ARespiratory acidosis
2. BMetabolic alkalosis
3. CMetabolic acidosis
4. DRespiratory alkalosis

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

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

Which measure is part of the bundle for inserting a central venous catheter to prevent bloodstream infection?

1. ARoutine replacement of the catheter on a fixed schedule, such as every three days
2. BGiving antibiotics to every patient before insertion
3. CChoosing the femoral vein as the first site in adults
4. DChlorhexidine-alcohol skin antisepsis and maximal sterile barrier precautions

During a disaster, the hospital needs to free beds quickly. Which patient is the best candidate for early discharge?

1. AA patient on an IV heparin infusion that is still being adjusted
2. BA patient admitted overnight for observation who is now stable with normal tests
3. CA patient with ongoing chest pain awaiting cardiac tests
4. DA patient on a ventilator in the intensive care unit who is slowly improving

A patient with schizophrenia is starting clozapine. Which laboratory value must be monitored regularly?

1. AAbsolute neutrophil count
2. BInternational normalized ratio
3. CSerum lithium level
4. DSerum amylase

A man of Mediterranean descent develops dark urine, jaundice and a falling hemoglobin a few days after eating fava beans. Which condition is most likely?

1. AVitamin B₁₂ deficiency anemia
2. BIron-deficiency anemia from poor diet
3. CG6PD deficiency with acute hemolysis
4. DSickle cell crisis with vaso-occlusion

Which side effect of regular opioids usually needs preventive treatment from the start?

1. ADiarrhoea
2. BConstipation
3. CExcessive hunger
4. DHigh blood pressure

A nurse notices that a wrong dose of a drug was prepared but was caught before it was given. What should be done?

1. ASay nothing, because no harm reached the patient
2. BDiscipline the nurse who prepared it on the spot in front of colleagues
3. CTell only the patient's family
4. DReport it as a near miss through the incident reporting system

A patient with an implantable cardioverter-defibrillator asks what to do if it fires. Which teaching is correct?

1. AIgnore any shock at all, because the device is designed to fire every day and needs no follow-up
2. BDrive straight to hospital alone after any shock so the device can be checked by the team
3. CRemove the device battery at home if it fires more than once
4. DOne shock and well: contact the device clinic; repeated shocks or unwell: call emergency services

A fit 24-year-old marathon runner has a resting heart rate of 46/min on admission for minor surgery. He has no dizziness, chest pain or breathlessness, and his BP is 118/70 mmHg. What is the appropriate response?

1. ADocument and report it, as this is often normal in an athlete
2. BStart chest compressions
3. CGive IV atropine straight away to bring the rate above 60/min
4. DCancel the surgery and arrange a permanent pacemaker urgently

After a change in the levothyroxine dose, when is the TSH usually rechecked?

1. AAfter 3 days
2. BAfter about 6–8 weeks
3. CAfter 24 hours
4. DAfter about 2 years of treatment

A patient who had pituitary surgery has fatigue and feels cold. TSH is low, and free T4 is low. What is the most likely cause?

1. AOver-replacement with levothyroxine
2. BHyperthyroidism from Graves' disease
3. CPrimary hypothyroidism from thyroid failure
4. DSecondary hypothyroidism

Which nursing intervention best reduces preoperative anxiety?

1. ATelling the patient that there is nothing to worry about
2. BExplaining what will happen and answering questions
3. CAvoiding talking about the operation at all
4. DKeeping family members away until after surgery

Ngày 3 sau một bỏng lớn, bệnh nhân bắt đầu đi tiểu lượng lớn. Điều dưỡng nên dự đoán rối loạn điện giải nào?

1. ATăng kali máu, khi tổn thương mô mới giải phóng kali
2. BTăng natri máu, khi thận bắt đầu giữ natri
3. CTăng calci máu, do nằm nghỉ và bất động
4. DHạ kali máu, khi dịch trở lại tuần hoàn