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

A patient is receiving opioids after surgery. Which finding usually comes before opioid-induced respiratory depression?

1. AIncreased appetite and thirst
2. BIncreasing sleepiness that is hard to rouse
3. CA rise in blood pressure with flushed cheeks
4. DA sudden rise in pain scores

An older patient has bruises of different ages and seems frightened when a relative visits. What is the nurse’s priority?

1. AIgnore it, because older people bruise easily
2. BAsk the relative directly in front of the patient whether they hit her
3. CEnsure the patient’s safety, document the findings and report as required
4. DTell the patient she must leave home and go to live somewhere else

Sputum specimens are ordered to look for acid-fast bacilli (TB). How are they usually collected?

1. AThree deep-cough specimens collected 8 to 24 hours apart, at least one early in the morning
2. BOne saliva sample collected at any convenient time of day
3. CThree specimens collected after an antiseptic mouthwash
4. DOne specimen of sputum collected straight after the evening meal, when coughing is easiest

A flexible bronchoscope contacts mucous membranes but does not enter sterile tissue. Which level of processing is required at a minimum between patients?

1. ACleaning with soap and water only
2. BHigh-level disinfection
3. CLow-level disinfection
4. DWiping with an alcohol wipe

A patient with HIV on antiretroviral therapy has an undetectable viral load. What does this mean?

1. AThe treatment is suppressing the virus very well
2. BThe virus has been completely cured and removed
3. CThe CD4 count must now be dangerously low too
4. DThe treatment can now be stopped without any risk

A patient started methimazole for hyperthyroidism 6 weeks ago and now has a fever and a severe sore throat. Which action is most important?

1. AAdvise the patient to continue the drug and drink more fluid
2. BHold the drug and arrange an urgent white cell and neutrophil count
3. CCheck the TSH and double the dose if it is still low
4. DGive the next dose and suggest warm salt-water gargles for comfort

Which side effects are common after high doses of salbutamol (albuterol)?

1. AConstipation and urinary retention
2. BHair loss and weight gain
3. CTremor and a fast heart rate
4. DBradycardia and drowsiness

After a high spinal cord injury, a patient has low blood pressure with a slow heart rate and warm, dry skin. What is most likely?

1. ACardiac tamponade
2. BNeurogenic shock
3. CHypovolaemic shock
4. DSeptic shock

After a bronchoscopy with throat anaesthesia, when can the patient eat and drink?

1. AOnly after a chest X-ray has been reported
2. BAfter a full 24 hours without food
3. CImmediately after the scope is removed
4. DWhen the gag and cough reflexes have returned

A 25-year-old non-smoker has wheeze and cough that come and go, worse at night and after exercise. Spirometry improves markedly after a bronchodilator. Which diagnosis is most likely?

1. AIdiopathic pulmonary fibrosis
2. BCOPD
3. CAsthma
4. DHeart failure

A patient with Graves' eye disease has gritty eyes and swelling around them in the morning. Which advice is most appropriate?

1. AUse lubricating drops and sleep with the head raised
2. BStay in bright sunlight to dry the eyes
3. CRub the eyes firmly each morning to reduce the swelling
4. DSmoking more will not affect the eyes

A haemodialysis patient missed their last two sessions. They are breathless, with crackles, and the potassium is 6,9 mmol/L. What is the priority?

1. AOral potassium supplements and rest
2. BUrgent dialysis, with cardiac monitoring meanwhile
3. CA routine dialysis session at the next planned slot
4. DLarge IV fluid boluses to improve the circulation

Which is a recognised risk of long-term proton pump inhibitor use?

1. AHypernatraemia
2. BHyperkalaemia
3. CHypomagnesaemia
4. DHypercalcaemia

A colleague suggests giving a saline injection to see whether a patient's pain is "real". What is the best response?

1. ADeceptive placebos are unethical and do not show pain is "fake"
2. BIt is acceptable if a senior nurse gives the saline
3. CIt is a good idea, as long as the patient is not told about it afterwards
4. DIt should be done only for patients with chronic pain