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

During an IV vancomycin infusion, a patient develops flushing and itching of the face and neck. What should the nurse do first?

1. AStop or slow the infusion and inform the provider
2. BSpeed up the infusion to finish it quickly
3. CIgnore it, because flushing is always harmless and passes
4. DApply a warm compress to the face and neck

On a cardiac step-down unit, which patient should the nurse assess first?

1. ASix hours after a coronary stent, new chest pain with ST elevation on the monitor
2. BAtrial fibrillation on warfarin with an INR of 2,6 this morning
3. CHeart failure, weight up 0,5 kg since yesterday, no breathlessness at rest
4. DDay 2 after a pacemaker insertion, asking when the wound dressing will be changed

A patient has orthostatic hypotension. Which teaching helps to prevent falls?

1. AStand up straight after a hot shower to increase blood flow
2. BAvoid drinking fluids in the morning to reduce trips to the toilet
3. CGet out of bed quickly so the dizziness passes sooner
4. DSit on the edge of the bed for a short time before standing up slowly

Trong lúc phát thuốc đường uống, một bệnh nhân xin uống viên thuốc sau. Điều dưỡng để viên thuốc trên bàn đầu giường. Vấn đề an toàn chính là gì?

1. AĐiều dưỡng không thể xác nhận thuốc đã được uống, và người khác có thể uống nhầm
2. BKhông có vấn đề an toàn nếu bệnh nhân tỉnh táo
3. CViên thuốc tan nhanh khi để ngoài không khí
4. DViên thuốc có thể mất màu và khó nhận dạng sau này

A patient on a heparin infusion has an aPTT below the target range on the protocol. What should the nurse do?

1. ASwitch the infusion to oral warfarin without a prescription
2. BAdjust the rate as the protocol directs and recheck as scheduled
3. CStop the infusion and give protamine sulfate as quickly as possible
4. DContinue the same rate and recheck the aPTT in a few days

A young man has a swollen knee after minor trauma. His aPTT is prolonged, but his PT/INR and platelet count are normal. Which condition fits best?

1. ADisseminated intravascular coagulation
2. BHemophilia A (factor VIII deficiency)
3. CImmune thrombocytopenia (ITP)
4. DVitamin K deficiency from poor diet

A nurse finds a patient lying on the floor beside the bed. What should be done first?

1. ACheck the patient for injuries before moving them
2. BComplete the incident report form
3. CPhone the patient's family
4. DLift the patient straight back into bed so they are comfortable

Bệnh nhân truyền vancomycin tĩnh mạch bị bừng mặt và phát ban đỏ ngứa ở mặt và cổ khi truyền nhanh. Nguyên nhân và xử trí có khả năng nhất là gì?

1. ACháy nắng; bôi kem và tiếp tục
2. BPhản ứng bình thường; tăng tốc độ truyền
3. CSuy gan; ngừng vĩnh viễn mọi thuốc
4. DPhản ứng liên quan đến truyền; ngừng hoặc giảm tốc độ truyền và báo cho người kê đơn

A 70 kg patient has passed 20 mL of urine per hour for the last three hours. How should this be interpreted?

1. AHigh, suggesting fluid overload that needs a diuretic
2. BBelow 0,5 mL/kg/h, suggesting poor kidney perfusion
3. CNormal, because the target is 0,1 mL/kg/h
4. DNormal, because any measurable urine output is reassuring

A patient who injects drugs has a fever, a new heart murmur and splinter haemorrhages. Before antibiotics are started, what is most important?

1. ATake several sets of blood cultures from separate sites
2. BArrange an exercise ECG test
3. CWait for an echocardiogram before taking any samples
4. DTake a single blood culture from the cannula

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

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

Which statement correctly distinguishes spinal shock from neurogenic shock?

1. ASpinal shock is lost reflexes; neurogenic shock is low BP and slow pulse
2. BNeurogenic shock is caused by blood loss; spinal shock is caused by infection
3. CSpinal shock is low blood pressure; neurogenic shock is the loss of reflexes
4. DThey are two names for exactly the same condition

Giai đoạn nào của lành vết thương liên quan đến sự hình thành mô hạt và mạch máu mới?

1. AGiai đoạn cầm máu (đông máu)
2. BGiai đoạn trưởng thành
3. CGiai đoạn viêm
4. DGiai đoạn tăng sinh

Which preoperative blood result should the nurse report to the team before elective surgery?

1. AFasting glucose 5,4 mmol/L (97 mg/dL)
2. BPotassium 2,9 mmol/L
3. CHaemoglobin 138 g/L (13,8 g/dL) in a man
4. DSodium 139 mmol/L