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

A patient has a reddened area on the sacrum that does not blanch when pressed. What is the priority action?

1. AMassage the area firmly to improve the blood flow to the skin
2. BRelieve pressure on the area by changing position regularly
3. CApply a heat pad to the area to increase circulation
4. DKeep the patient lying on the back to protect the area

Which finding after a laparoscopic cholecystectomy is expected and needs only reassurance and comfort measures?

1. AIncreasing abdominal pain with a temperature of 39 °C
2. BRight shoulder pain from the gas used during surgery
3. CYellow skin with dark urine on the second day
4. DA heart rate of 125/min with a falling blood pressure

Why is blood glucose control important around the time of surgery?

1. AHigh glucose impairs white cell function and raises the risk of surgical site infection
2. BHigh glucose makes anesthetic drugs work for much longer and delays waking up
3. CLow glucose is needed around surgery so that the wound edges close more quickly
4. DGlucose levels only affect patients who have type 1 diabetes

Y lệnh viết tay ghi "10U regular insulin subcut now". Hành động tốt nhất của điều dưỡng là gì?

1. ALàm rõ y lệnh, vì "U" có thể bị đọc nhầm
2. BNhờ hộ lý đọc giúp chữ viết tay
3. CCho 10 đơn vị mà không thắc mắc, đúng như viết
4. DCho 100 đơn vị, như y lệnh có vẻ ghi

Một người bệnh có số lượng tiểu cầu 18 × 10³/µL. Biện pháp điều dưỡng nào phù hợp?

1. AKhuyến khích dùng chỉ nha khoa hai lần mỗi ngày và cạo râu bằng lưỡi dao sắc
2. BBàn chải đánh răng mềm, dao cạo điện và không tiêm bắp
3. CĐo nhiệt độ hậu môn mỗi bốn giờ cho chính xác
4. DCho aspirin đã kê khi người bệnh đau đầu

A patient has fever, confusion, a platelet count of 15 × 10³/µL, anemia with fragmented red cells (schistocytes) and a raised creatinine. Clotting times are normal. Which condition should be suspected?

1. AThrombotic thrombocytopenic purpura (TTP)
2. BDisseminated intravascular coagulation
3. CImmune thrombocytopenia (ITP)
4. DVitamin K deficiency with bleeding

A patient has lost more than 10% of their body weight without trying over the last few months and has a low BMI. What is the most appropriate action?

1. ARefer to the dietitian and start a nutrition care plan with food charts
2. BWeigh the patient again in six months and review at that point
3. CEncourage a low-calorie diet
4. DRestrict fluids to encourage appetite and give a low-protein diet instead

Ngay sau khi bắt đầu truyền máu, bệnh nhân khó thở, khò khè và hạ huyết áp kèm phù mặt. Điều dưỡng nên làm gì trước tiên?

1. ACho paracetamol và thuốc kháng histamine rồi tiếp tục truyền máu
2. BNgừng truyền máu, giữ đường truyền tĩnh mạch và gọi trợ giúp khẩn cấp
3. CGiảm tốc độ truyền và kiểm tra lại các chỉ số sau một giờ
4. DTruyền nhanh hết đơn vị máu để thời gian phơi nhiễm ngắn nhất có thể

A patient with angle-closure glaucoma needs nebulised ipratropium. What precaution is sensible?

1. AUse a mouthpiece or protect the eyes from the mist
2. BGive it only with the patient lying completely flat
3. CMix it with an eye drop before putting it in the nebuliser
4. DRun it at the highest possible gas flow

A nurse reviews inhaler use with a patient who has asthma and uses a separate steroid preventer inhaler and a salbutamol reliever. Which statement shows a need for further teaching?

1. A"I use my steroid inhaler every day, even when I feel well."
2. B"I carry my blue reliever inhaler with me."
3. C"I use my steroid inhaler when I start to wheeze."
4. D"I rinse my mouth after the steroid inhaler."

Why does a patient with untreated hypothyroidism need extra care when given opioids or sedatives?

1. AThey break the drugs down slowly and are more sensitive to them
2. BThere is no difference compared with other patients
3. CThey clear the drugs too fast, so higher doses are needed
4. DThese drugs make the thyroid gland overactive

Near the end of a haemodialysis session, a patient has painful leg cramps and a falling blood pressure. What is the most likely cause?

1. AAn allergic reaction to the needles
2. BFluid is being removed too quickly
3. CNot enough fluid is being removed
4. DThe dialysate is too cold

Which complication is more typical of Crohn's disease than of ulcerative colitis?

1. AInflammation limited to the rectal lining
2. BFistulas between the bowel and other organs
3. CDisease that is cured by removing the colon
4. DBleeding only from the rectum

Four hours after surgery, a catheterised patient's urine output has been 10 mL/h for two hours. Vital signs are stable. What should the nurse check first?

1. AWhether the patient wants a cup of tea
2. BThe time the patient last ate
3. CYesterday's chest X-ray and blood gas results
4. DThat the catheter and tubing are not kinked or blocked