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

Một phụ tá điều dưỡng báo huyết áp của người bệnh là 168/98 mmHg (trước đó là 130/80) và người bệnh đau đầu. RN nên làm gì?

1. AGhi lại giá trị và tiếp tục vòng phát thuốc
2. BNhờ phụ tá đo lại huyết áp sau một giờ
3. CNhờ phụ tá cho thuốc hạ huyết áp theo nhu cầu ngay bây giờ
4. DĐánh giá người bệnh, đo lại huyết áp và tìm triệu chứng

The charge nurse overhears four instructions from an RN to a nursing assistant. Which one needs to be corrected?

1. A“Help him wash and change, and tell me at once if you see any red or broken skin.”
2. B“Check his glucose and give the insulin according to the sliding scale.”
3. C“Walk him to the bathroom and back, and stay with him the whole time.”
4. D“Check his glucose before lunch and tell me the number straight away.”

A patient with a respiratory infection has a raised procalcitonin level. What does this most suggest?

1. ADehydration from poor intake
2. BA bacterial rather than a viral infection
3. CAn allergic reaction to a recent medication
4. DA purely viral illness

A nurse finds an unknown liquid leaking from a container in the utility room, with a strong smell. What should the nurse do first?

1. ALeave the area, keep others out and alert the trained response team
2. BMop it up with paper towels
3. CPour water over it to dilute it
4. DMove closer and smell it carefully to identify what the substance is

A patient with a potassium of 2,8 mEq/L has potassium chloride prescribed IV. Which statement about giving it is correct?

1. AIt may be given as a slow IV push over one minute if the level is very low
2. BIt is given as an undiluted bolus into a large vein to avoid irritation
3. CIt is always diluted and given by infusion pump, never as an IV push
4. DIt is added to the IV bag without mixing, so it stays at the bottom

A patient with diabetes and chronic kidney disease had a CT scan with IV contrast. Two days later, the creatinine has risen from 1,4 to 2,0 mg/dL (124 to 177 µmol/L). Which action is most appropriate?

1. ARestrict all fluids to protect the kidneys from more contrast
2. BIgnore it, because contrast never affects kidney function
3. CReport it, monitor urine output and hold metformin until reviewed
4. DGive extra metformin, because the glucose rises after contrast

What should a patient be told before using sublingual glyceryl trinitrate (GTN, nitroglycerin) spray for angina?

1. AUse it only after the pain has lasted over an hour, with the patient lying flat
2. BSwallow the spray rather than leaving it under the tongue
3. CTake it with a large glass of milk to protect the stomach lining
4. DSit down before using it, as it can cause dizziness and low blood pressure

A patient faints during cannulation, with a slow pulse and pallor, and recovers quickly when laid flat. There is no rash, wheeze or swelling. What is most likely?

1. AA stroke
2. BAnaphylaxis
3. CA hypoglycaemic coma
4. DVasovagal syncope

Phối hợp nhóm thuốc nào cải thiện sống còn trong suy tim phân suất tống máu giảm?

1. AThuốc lợi tiểu quai, digoxin, nitrate và thuốc chẹn kênh calci
2. BThuốc ức chế men chuyển hoặc ARNI, thuốc chẹn beta, MRA và thuốc ức chế SGLT2
3. CNSAID, aspirin, statin và thuốc lợi tiểu thiazide
4. DChỉ một thuốc lợi tiểu quai ở liều cao nhất dung nạp được

Một bệnh nhân bệnh động mạch ngoại biên đã biết đột ngột có bàn chân lạnh, trắng, đau, không có mạch và tê các ngón chân. Ưu tiên là gì?

1. AKhuyến khích đi bộ để mở tuần hoàn bàng hệ
2. BBăng ép để cải thiện tuần hoàn
3. CBáo động ngay như một cấp cứu; giữ chân ngang bằng, không chườm nóng
4. DKê chân cao trên gối và làm ấm bàn chân bằng túi nước nóng

A patient with type 1 diabetes has gastroenteritis and cannot eat. Which sick-day advice is correct?

1. ACheck glucose once a day only and rest in bed until better
2. BKeep taking basal insulin and check glucose and ketones more often
3. CStop all insulin until normal eating restarts
4. DAvoid drinking fluids to reduce the vomiting

Two days after a spinal cord injury, a patient has a swollen abdomen, no bowel sounds and is vomiting. What is most likely, and what is the nursing action?

1. AAn allergic reaction to food, so give an antihistamine
2. BParalytic ileus, so keep nil by mouth and prepare for an NG tube
3. CA full bladder, so encourage oral fluids
4. DNormal constipation, so give a large meal to stimulate the bowel

Which infection control measure is correct for a patient with C. difficile diarrhoea?

1. AA shared bay, as long as alcohol gel is used after every contact
2. BNo special measures once antibiotics have started
3. CA single room with its own toilet, and soap-and-water handwashing
4. DA face mask for the patient and visitors only

An older patient with atrial fibrillation has sudden severe abdominal pain, but the abdomen is soft with little tenderness. Lactate is raised. What should the nurse suspect?

1. AMuscle strain from coughing
2. BIrritable bowel syndrome
3. CAcute mesenteric ischaemia
4. DSimple constipation