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

A patient receiving chemotherapy has a temperature of 38,3 °C and a very low neutrophil count. What should the nurse do?

1. ARecheck the temperature in four hours before telling anyone
2. BDocument the reading and mention it at the next handover
3. CReport it at once, because cultures and antibiotics are needed quickly
4. DGive a cool shower and offer extra fluids, then wait and see what happens

Trong phân loại START, một người lớn không đi được thở 28 lần/phút, không có mạch quay và thời gian đổ đầy mao mạch 4 giây. Nạn nhân được xếp loại nào?

1. AĐỏ (cấp cứu ngay)
2. BVàng (trì hoãn), vì tần số thở dưới 30 lần/phút
3. CXanh lá (nhẹ)
4. DĐen (chờ đợi)

Which kitchen practice helps prevent scald burns in young children?

1. ATurn pot handles toward the back of the stove
2. BLeave hot drinks at the edge of the table
3. CHold the child while drinking a hot drink
4. DLet the child stand on a chair beside the stove

Khi nhập viện, danh sách thuốc ở nhà có một thuốc chống đông không có trong y lệnh mới của bệnh viện. Điều dưỡng nên làm gì?

1. ACho liều ở nhà mà không có y lệnh
2. BBỏ qua, vì y lệnh bệnh viện thay thế thuốc ở nhà
3. CLàm rõ sự khác biệt với người kê đơn
4. DBảo bệnh nhân lén uống thuốc tự mang theo

When several samples are drawn at the same venipuncture, which tubes or bottles are filled first?

1. ABlood culture bottles
2. BFluoride (glucose) tubes
3. CCoagulation (citrate) tubes
4. DEDTA (complete blood count) tubes

A patient's creatinine was 0,9 mg/dL (80 µmol/L) on admission and is 1,3 mg/dL (115 µmol/L) 36 hours later. Using the common KDIGO criteria, what does this show?

1. AA laboratory error, because creatinine cannot change within 2 days
2. BNo kidney injury, because the creatinine is still within the normal range
3. CChronic kidney disease, because creatinine has risen above baseline
4. DAcute kidney injury, because it rose by at least 0,3 mg/dL within 48 hours

Bụng bệnh nhân cứng như tấm ván, và họ nằm rất yên vì cử động làm đau tăng. Điều này gợi ý gì?

1. AViêm phúc mạc
2. BTáo bón
3. CNhiễm trùng tiết niệu
4. DKhó tiêu

An adult with capacity refuses a blood transfusion for religious reasons, even though it may save their life. What should the nurse do?

1. AAsk a family member to consent instead
2. BSedate the patient so the transfusion can be given
3. CGive the transfusion while the patient is asleep, as it is in their best interests
4. DRespect the refusal, check it is informed and document it, and inform the team

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

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

After chest trauma, a patient is hypotensive with reduced breath sounds on the left. Which finding suggests a haemothorax rather than a tension pneumothorax?

1. ADistended neck veins
2. BTrachea pushed away from the affected side
3. CHyper-resonance on the affected side
4. DDullness to percussion on the affected side

A patient on insulin asks about drinking alcohol. Which advice is correct?

1. AAlcohol can cause hypos, even the next day, so eat carbs with it
2. BAlcohol should replace a meal on the days it is drunk
3. CAlcohol has no effect on blood glucose in people with diabetes
4. DAlcohol raises glucose, so extra insulin should be taken first

A patient with type 1 diabetes has a seizure on the ward. Their capillary glucose is 1,9 mmol/L (34 mg/dL). They cannot swallow. What is the most appropriate treatment?

1. AA rapid-acting insulin dose to stabilise the glucose
2. BIV glucose or IM glucagon, then recheck the glucose
3. CGlucose gel squeezed into the mouth during the seizure
4. DAn antiepileptic drug only, because seizures need seizure treatment

Why is pethidine (meperidine) generally avoided for regular pain relief?

1. AIt has no pain-relieving effect at all in adults
2. BIt always causes severe diarrhoea
3. CA metabolite can build up and cause seizures
4. DIt can only be given by mouth

A patient with advanced cancer who has capacity decides to stop chemotherapy. The family insists that treatment must continue. What should the nurse do?

1. ATell the patient that stopping is not allowed
2. BAsk the family to sign a new consent form
3. CSupport the patient's decision and help the team talk with the family
4. DContinue treatment because the family has asked for it