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

A patient taking clozapine reports a sore throat and fever. What is the priority action?

1. AHold the dose and report so the white cell count can be checked
2. BIncrease the dose because the symptoms suggest a relapse
3. CAdvise the patient to gargle with warm salt water and rest in bed
4. DOffer throat lozenges and continue the usual dose

At 08:00 a nurse has four tasks. Which order is best?

1. AGive routine medications, check the patient with a falling SpO₂, update care plans, give insulin with breakfast
2. BCheck the patient with a falling SpO₂, give insulin with breakfast, give routine medications, update care plans
3. CUpdate care plans, give insulin with breakfast, give routine medications, check the patient with a falling SpO₂
4. DGive insulin with breakfast, update care plans, check the patient with a falling SpO₂, give routine medications

A new antibiotic is prescribed for a patient. What should the nurse check before giving the first dose?

1. AOnly the time of the patient’s last meal and drink
2. BOnly the patient’s blood pressure and pulse before giving the drug
3. CThe patient’s allergies, by checking the record and asking the patient
4. DThe patient’s preferred pharmacy

A patient on oxygen needs an MRI scan. Which plan is safe?

1. ATake the usual steel cylinder into the room if it is tightly strapped to the trolley frame
2. BLeave the steel cylinder on the patient’s bed during the scan
3. CRemove the oxygen for the scan without telling anyone
4. DUse only MRI-safe equipment, and never take a standard steel oxygen cylinder into the scanner room

When should the nurse check the glucose before giving a mealtime dose of rapid-acting insulin (such as lispro)?

1. AOnly once a day, then giving the same dose before every meal
2. BAt bedtime only, then giving the mealtime insulin overnight
3. CJust before the meal, giving insulin when the food is ready
4. DTwo hours after the meal, then giving the insulin dose

A patient admitted with heavy alcohol use and malnutrition has a glucose of 52 mg/dL (2,9 mmol/L) and low magnesium. Which prescribed treatment should be given before the IV glucose?

1. AIV insulin
2. BIV thiamine
3. CIV potassium
4. DOral iron

A patient is started on spironolactone while already taking an ACE inhibitor. Which blood result should be watched most closely?

1. APotassium, because both drugs can raise it
2. BSodium, because both drugs raise it sharply
3. CGlucose, because both drugs cause hyperglycaemia
4. DCalcium, because both drugs lower it

The fluid in an underwater seal chest drain has stopped swinging with breathing. What could this mean?

1. AThe patient's breathing has become normal and the drain can be pulled out by the nurse
2. BThe water seal has been set up correctly for the first time
3. CThe tube may be kinked or blocked, or the lung may have fully re-expanded
4. DThe drain is working perfectly and needs no checks

Which feature of a COPD exacerbation most suggests that antibiotics are needed?

1. AA dry, tickly cough with no sputum at all for a day
2. BA mild sore throat that lasted for one day only
3. CA clear runny nose
4. DAn increase in purulent (green or yellow) sputum

Một bệnh nhân đau ngực có ST chênh lên ở chuyển đạo II, III và aVF. Huyết áp 86/54 mmHg, phổi trong và tĩnh mạch cổ căng. Điều dưỡng nên đặt câu hỏi về thuốc nào đã được kê?

1. AGlyceryl trinitrate ngậm dưới lưỡi
2. BAspirin 300 mg nhai
3. CThuốc chống nôn tĩnh mạch
4. DOxy nếu SpO₂ xuống dưới mục tiêu

A patient's potassium stays low despite replacement. Which other level should be checked?

1. ABilirubin
2. BFerritin
3. CAmylase
4. DMagnesium

Three days after a stroke, a patient with dysphagia on a modified diet has a temperature of 38,2 °C (100,8 °F), a respiratory rate of 24/min and crackles at the right lung base. What should the nurse do?

1. AGive paracetamol (acetaminophen) and continue the modified diet as before
2. BEncourage more fluids by mouth to treat the fever
3. CRecord the findings and recheck them at the next routine observation
4. DSuspect aspiration pneumonia, stop oral intake and escalate for review

How can low-dose opioids help a patient with breathlessness from advanced cancer?

1. AThey reduce the feeling of breathlessness
2. BThey cure the underlying lung disease
3. CThey open the airways like an inhaler
4. DThey increase the oxygen level in the blood

A patient with diabetes has rapidly spreading redness around a small wound, severe pain out of proportion, fever and crackling under the skin. What should the nurse suspect?

1. AA healing venous ulcer
2. BMild contact dermatitis
3. CNecrotising fasciitis
4. DA simple insect bite