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

A nursing assistant offers to suction a patient’s new tracheostomy. Which response from the RN is best?

1. A“Ask the patient’s family to do the suctioning today.”
2. B“Suctioning a new tracheostomy is my task; I will do it myself.”
3. C“Leave the suctioning until the next shift arrives.”
4. D“Thank you, please suction him as needed and tell me how it went.”

During an infusion of a thrombolytic drug for stroke, the patient develops a severe headache and starts vomiting. What should the nurse do first?

1. AGive a dose of aspirin for the headache
2. BContinue the infusion, because headache is expected
3. CSlow the infusion and give an antiemetic as prescribed
4. DStop the infusion and inform the provider at once

Many intensive care units bathe patients daily with chlorhexidine. What is the main purpose?

1. ATo reduce skin bacteria and bloodstream infections linked to central lines
2. BTo lower the patient’s body temperature
3. CTo treat existing wound infections without the need for antibiotics
4. DTo moisturize dry skin in older patients

A visitor is receiving an electric shock from a faulty lamp and is still touching it. What should the nurse do first?

1. ASwitch off the power or unplug the lamp without touching the person
2. BStart chest compressions straight away
3. CThrow water over the lamp to stop the current
4. DPull the visitor away from the lamp by the arm as quickly as possible

Nồng độ đáy vancomycin cao hơn khoảng mục tiêu. Tác dụng không mong muốn nào là mối lo chính?

1. ASố lượng tiểu cầu tăng (tăng tiểu cầu)
2. BTáo bón và đầy hơi
3. CĐường huyết thấp (hạ đường huyết)
4. DTổn thương thận (độc thận)

A patient has a continuous heparin infusion for a pulmonary embolism. A new nurse plans to adjust the infusion using today's INR of 1,1. What should the experienced nurse explain?

1. AHeparin needs no laboratory monitoring once the infusion is started
2. BHeparin is adjusted using the aPTT or anti-Xa level, not the INR
3. CThe INR of 1,1 means the heparin rate must be doubled at once
4. DThe INR is the correct test, and 1,1 means heparin is therapeutic

Which statement about storing insulin is correct?

1. AInsulin never expires once opened
2. BInsulin should be kept in direct sunlight
3. CUnopened insulin is kept in the fridge and must not be frozen
4. DAll insulin should be stored in the freezer to keep it fresh

Bệnh nhân dùng steroid lâu dài ốm nặng cấp tính sau khi nôn và bỏ liều, với hạ huyết áp và lú lẫn. Cần cân nhắc cấp cứu nào?

1. AĐái tháo nhạt
2. BCơn suy thượng thận cấp
3. CTăng calci máu
4. DCơn bão giáp

A patient with a long QT interval develops a polymorphic ventricular tachycardia that twists around the baseline but still has a pulse. Which drug is used first?

1. AIntravenous magnesium sulfate
2. BOral digoxin
3. CIntravenous adenosine
4. DIntravenous potassium chloride as a bolus

A patient with a tracheostomy suddenly becomes distressed, and a suction catheter will not pass down the tube. What should the nurse do first?

1. AGive a nebulised bronchodilator
2. BInflate the cuff with more air
3. CIncrease the oxygen and wait
4. DRemove the inner cannula

A patient takes levodopa for Parkinson's disease. Which teaching point is correct?

1. AThe drug cures the disease if taken for a full year
2. BStop the drug for a day each week to avoid tolerance
3. CThe tablets work best taken with a large steak dinner
4. DLarge high-protein meals can reduce how well the drug works

A patient arrives five hours after the onset of a stroke. A CT angiogram shows a blockage of a large artery in the brain. What is the most appropriate next step?

1. ANo treatment, because the time for any reperfusion has passed
2. BStart IV alteplase immediately without further imaging
3. CGive aspirin and plan a review on the ward tomorrow
4. DUrgent referral for assessment for mechanical thrombectomy

Which statement about fatigue during radiotherapy is correct?

1. AIt means the radiotherapy has failed
2. BIt is caused by the patient becoming radioactive
3. CIt often builds during the course and can last for weeks
4. DIt occurs only after the first session and then disappears completely

A patient taking IV antibiotics has three unexplained loose stools in 24 hours. What should the nurse do first?

1. AMove the patient to a bay with other patients to watch them closely
2. BIsolate the patient and send a stool sample for testing
3. CWait two days to see if the diarrhoea settles
4. DGive loperamide after each loose stool and continue as usual