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

Một điều dưỡng ủy quyền đo dấu hiệu sinh tồn thường quy cho phụ tá điều dưỡng với một người bệnh có huyết áp đang tụt trong một giờ qua. Điều "đúng" nào của ủy quyền không được đáp ứng?

1. AĐúng hướng dẫn và giao tiếp
2. BĐúng người
3. CĐúng hoàn cảnh
4. DĐúng nhiệm vụ, vì dấu hiệu sinh tồn không bao giờ được ủy quyền

Trong phân loại START, một người lớn không đi được thở 24 lần/phút, có mạch quay, nhưng không làm theo được mệnh lệnh đơn giản. Nạn nhân được xếp loại nào?

1. AXanh lá (nhẹ)
2. BĐỏ (cấp cứu ngay)
3. CVàng (trì hoãn)
4. DĐen (chờ đợi)

Which technique is used for suctioning a tracheostomy in hospital?

1. AClean technique, reusing the catheter during the shift
2. BClean technique, with the catheter rinsed in tap water
3. CNo gloves at all, because the airway already contains bacteria
4. DSterile technique, with a sterile catheter and sterile glove

A patient in a vest restraint has slid down in bed, and the vest is pressing against the neck. What should the nurse do first?

1. AWrite a note about the event in the chart
2. BRelease the restraint at once and reposition the patient
3. CTighten the vest so the patient cannot slide down again
4. DCall the provider to ask about a different restraint

A patient on peritoneal dialysis notices that the drained fluid is cloudy and has abdominal pain. What should the nurse do?

1. AAdd more glucose to the next bag to clear the fluid
2. BStop dialysis for a week and recheck the fluid later
3. CRecord it as normal and continue the usual exchanges
4. DSend the fluid for cell count and culture and report it

A patient on digoxin has a calcium of 12,1 mg/dL (3,0 mmol/L) and new nausea and a slow pulse. Why is the calcium result important?

1. AHigh calcium only matters if the potassium is also high
2. BHigh calcium increases the risk of digoxin toxicity
3. CHigh calcium blocks digoxin, so the drug stops working
4. DHigh calcium makes the kidneys clear digoxin faster

Why is an urgent brain scan needed before thrombolysis for a suspected stroke?

1. ATo measure the size of the ventricles
2. BTo confirm the patient's age
3. CTo rule out bleeding in the brain
4. DTo check for brain tumours only

A patient with type 1 diabetes is nil by mouth before surgery. Why must their insulin not simply be stopped?

1. AStopping insulin causes immediate hypoglycaemia during the operation
2. BInsulin is needed for the anaesthetic to work
3. CWithout any insulin they can develop diabetic ketoacidosis
4. DInsulin prevents wound infection on its own

A young patient with hypertrophic cardiomyopathy asks why they are told to avoid dehydration. What is the best explanation?

1. AFluids dissolve the extra muscle in the heart wall
2. BDehydration makes the heart muscle grow thicker within a few hours
3. CDehydration is the cause of the inherited condition
4. DLow blood volume can worsen obstruction of blood leaving the heart

A patient with obstructive sleep apnoea who uses CPAP at home is having surgery. Which plan is safest after the operation?

1. AUse their CPAP machine and monitor closely, using opioids with caution
2. BGive extra opioids so the patient sleeps through the night
3. CNurse the patient lying flat on their back to keep the airway open
4. DLeave the CPAP machine at home, as it is not needed while in hospital

Which signs suggest rejection of a kidney transplant?

1. AMore urine, a falling creatinine and weight loss
2. BLess urine, a rising creatinine and a tender graft
3. CA rash on the face after sun exposure
4. DA cough, wheeze and a runny nose with sneezing

A patient with Addison's disease has been vomiting for a day. They are confused, with BP 78/40 mmHg, sodium 126 mmol/L and potassium 6,0 mmol/L. What is the priority?

1. AIV hydrocortisone straight away, plus IV fluids
2. BOral hydrocortisone and an antiemetic by mouth
3. CA fluid restriction for the low sodium
4. DIV potassium to correct the electrolytes

Which drug class is used to reduce the risk of a first variceal bleed in cirrhosis?

1. AThiazide diuretics
2. BCalcium supplements
3. CProton pump inhibitors
4. DNon-selective beta-blockers

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. ASupport the patient's decision and help the team talk with the family
2. BTell the patient that stopping is not allowed
3. CContinue treatment because the family has asked for it
4. DAsk the family to sign a new consent form