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

Several patients on a gastroenterology unit need care. Which patient should the nurse see first?

1. ATwo hours after a colonoscopy: rigid abdomen and severe new pain
2. BLong-standing back pain, asking for the usual analgesic
3. CCrohn disease, waiting to be taken down for a scheduled CT scan
4. DUlcerative colitis, asking about diet changes for home

Before surgery, a nurse is asked to witness a patient’s consent. The patient was given a sedative 30 minutes ago. What should the nurse do?

1. AAsk a family member to sign on the patient’s behalf
2. BWitness it quickly before the sedative takes full effect
3. CWitness it and write “sedated” beside the signature
4. DNot witness the consent and inform the surgeon

A nurse cleans an IV pump with a disinfectant wipe. What must happen for the disinfectant to work?

1. AThe surface stays wet for the contact time on the product label
2. BThe surface is dried with a clean towel right after wiping
3. CThe wipe is used on many pumps to save product
4. DThe surface is wiped once lightly without pressure

A patient’s WBC is 4,000/mm³, with 30% neutrophils and 5% bands. What is the absolute neutrophil count (ANC)?

1. A140/mm³
2. B1,200/mm³
3. C1,400/mm³
4. D3,500/mm³

A patient receives repeated nebulized albuterol (salbutamol) for severe asthma. Which laboratory change should the nurse watch for?

1. AA rise in serum sodium
2. BA rise in serum calcium
3. CA fall in blood glucose
4. DA fall in serum potassium

A patient taking an SGLT2 inhibitor has nausea and fast breathing. Glucose 190 mg/dL (10,5 mmol/L), pH 7,15, bicarbonate 10 mEq/L, blood ketones high. What is the most likely diagnosis?

1. ARespiratory acidosis from COPD
2. BHyperosmolar hyperglycemic state
3. CSimple fasting ketosis only
4. DEuglycemic diabetic ketoacidosis

Which is a first-line nursing measure to help prevent constipation in hospital?

1. AGiving an enema to every patient on admission
2. BKeeping the patient in bed
3. CRestricting fluids to reduce urine output
4. DEncouraging fluids, fibre and mobility

A patient is admitted with suspected meningococcal disease. Which infection control measure is usually needed?

1. AAirborne precautions with a negative-pressure room for the whole hospital stay
2. BNo precautions, because it is not contagious
3. CIsolation only after the patient has gone home
4. DDroplet precautions until 24 hours of effective antibiotics have been given

What is the purpose of cardiac resynchronisation therapy (a biventricular pacemaker)?

1. ATo make both ventricles contract together and more efficiently
2. BTo replace a damaged heart valve
3. CTo deliver a shock whenever the heart rate exceeds 100/min
4. DTo slow the atrial rate in patients with atrial fibrillation

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

Which headache feature most suggests raised intracranial pressure from a brain tumour?

1. AWorse on waking and on coughing, with vomiting
2. BBetter in the morning and worse with stress
3. CA tight band across the forehead that eases with rest
4. DOnly present after reading for a long time

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. AStart sepsis care at once, with IV antibiotics and fluids
2. BEncourage oral fluids and wait for the urine culture
3. CTreat the confusion with a sedative
4. DGive oral antibiotics and recheck in four hours

How is an uncomplicated sigmoid volvulus often first treated?

1. AEating a large high-fibre meal
2. BHigh-dose laxatives taken by mouth
3. CA barium meal given by mouth to untwist the bowel slowly
4. DDecompression with a flexible sigmoidoscope and flatus tube

A patient's long-standing groin hernia has become tender, red and irreducible, and they are vomiting. What should the nurse do?

1. AApply a hot water bottle and give a laxative
2. BAdvise the patient to wear a tight truss and rest
3. CKeep them nil by mouth and arrange urgent surgical review
4. DPush the hernia firmly back in, then discharge home