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

Five days after starting heparin, a patient’s platelet count has fallen by more than half. What should the nurse suspect?

1. AVitamin K deficiency
2. BAn expected effect that needs no action
3. CIron deficiency anemia
4. DHeparin-induced thrombocytopenia

A patient has full-thickness burns all the way around the chest and is finding it harder to breathe, although the airway is clear. What does this suggest?

1. AThe patient has had too little IV fluid and needs a fast bolus to improve the breathing
2. BThe tight burned skin is restricting chest movement, so an escharotomy may be needed
3. CThe patient is anxious and only needs reassurance
4. DThe burns are healing and the skin is tightening normally

A patient is on suicide precautions. Which room safety measure is appropriate?

1. ALet the patient keep a personal razor for shaving, as long as staff are told
2. BAllow glass bottles if the patient seems calm
3. CRemove items that could be used for self-harm, such as belts and cords
4. DKeep the door closed at all times so the patient has privacy

A nurse teaches a patient with neutropenia about preventing infection at home. Which statement shows a need for further teaching?

1. A“I will avoid crowds and people who have colds.”
2. B“I will check my temperature and call if I have a fever.”
3. C“I will wash my hands often and ask visitors to do the same.”
4. D“I can clean the cat’s litter box if I wear a face mask.”

Đường huyết lúc đói hôm nay của một người bệnh là 98 mg/dL (5,4 mmol/L), nhưng HbA1c là 8,9% (74 mmol/mol). Cách diễn giải tốt nhất là gì?

1. AKết quả tốt hôm nay cho thấy đái tháo đường được kiểm soát tốt
2. BNgười bệnh không bị đái tháo đường
3. CHbA1c chỉ phản ánh 24 giờ qua
4. DKiểm soát đường huyết kém trong 2–3 tháng qua

Bộ kết quả nào điển hình nhất của thiếu máu thiếu sắt?

1. AHemoglobin thấp, hồng cầu to (MCV cao) và ferritin cao
2. BHemoglobin bình thường chỉ với số lượng tiểu cầu cao
3. CHemoglobin cao và hematocrit cao
4. DHemoglobin thấp, hồng cầu nhỏ (MCV thấp) và ferritin thấp

Which measure helps reduce the risk of surgical site infection?

1. ALeaving the patient cool during surgery to slow bacterial growth
2. BRemoving hair, if needed, with clippers rather than a razor
3. CChanging the wound dressing every hour
4. DShaving the area with a razor the night before surgery

Hai ngày sau cắt đoạn ruột, bệnh nhân đau tăng, sốt, nhịp tim nhanh và dịch trông như phân trong ống dẫn lưu vết mổ. Điều gì có khả năng nhất?

1. ARò miệng nối
2. BBí tiểu
3. CTáo bón
4. DHồi phục bình thường sau phẫu thuật

How does intermittent pneumatic compression help prevent DVT?

1. AIt breaks up and dissolves clots that have already formed in the veins
2. BIt keeps the legs completely still to protect the veins
3. CIt squeezes the legs in cycles to push venous blood towards the heart
4. DIt warms the legs gently so the blood becomes thinner and flows faster

A patient with both COPD and heart disease is more breathless, with bilateral basal crackles, raised JVP, ankle swelling and a markedly raised NT-proBNP. Which problem is most likely driving this episode?

1. ADecompensated heart failure
2. BHyperventilation from anxiety
3. CAn asthma attack
4. DA primary spontaneous pneumothorax

A nurse is teaching a patient going home after a mild concussion. Which statement shows a need for further teaching?

1. A"I will come back if I start vomiting again and again."
2. B"Someone will stay with me for the first night."
3. C"I will return if my headache gets steadily worse."
4. D"A few drinks tonight will help me relax and sleep."

A patient with SIADH needs IV fluid. Which fluid is most likely to worsen the hyponatraemia?

1. A3% saline
2. B8,4% sodium bicarbonate
3. C5% glucose (dextrose, D5W)
4. D20% human albumin

A patient is starting regular oral morphine. Which bowel advice is most appropriate?

1. AStart a regular laxative at the same time
2. BStop eating fibre completely
3. CTake a bulk-forming laxative only with very little water
4. DWait until there has been no stool for a week

On day 2 of nasogastric feeding, a severely malnourished patient becomes weak and breathless with ankle swelling. Phosphate is 0,4 mmol/L. What is most likely?

1. AAn allergy to the feed formula
2. BRefeeding syndrome
3. CToo little calorie intake
4. DNormal adjustment to the new feed