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

Which patient is most suitable for the nurse to assign to a nurse who has just finished orientation?

1. AA patient with a new tracheostomy who needs frequent suctioning
2. BA patient with sepsis whose blood pressure is falling
3. CA patient on a continuous heparin infusion with rising aPTT values
4. DA patient with stable cellulitis on scheduled IV antibiotics

A patient has a heart rate of 38/min, feels dizzy and has a blood pressure of 80/50 mmHg. Which drug is usually given first, as prescribed?

1. ADiltiazem
2. BMetoprolol
3. CDigoxin
4. DAtropine

A patient in bed has a generalized tonic-clonic seizure. What should the nurse do?

1. ATurn the patient on their side and protect them from injury without restraining
2. BGive sips of water to keep the airway moist
3. CHold the arms and legs firmly to stop the movements
4. DPut a padded tongue blade between the teeth to protect the tongue from biting

A nurse has worked three long shifts in a row and feels exhausted. The manager asks the nurse to stay for another shift. What is the most appropriate response?

1. AAgree and drink extra coffee to stay alert
2. BAgree, but skip the independent medication checks to save energy on the shift
3. CExplain that fatigue would make care unsafe and decline the extra shift
4. DAgree without telling anyone about the fatigue

Which change in clotting tests is normal in late pregnancy?

1. AFibrinogen and D-dimer rise
2. BPlatelets rise above 600 × 10³/µL
3. CaPTT doubles from baseline
4. DINR rises to about 3,0

A patient with SIADH is on fluid restriction. Which task can the RN delegate to unlicensed assistive personnel (UAP), such as a nursing or healthcare assistant?

1. ATeaching the reasons for fluid restriction
2. BAssessing the patient for new confusion
3. CDeciding when to recheck the sodium level
4. DMeasuring and recording intake and output

A patient with DKA has an arterial blood gas showing a low pH and a low bicarbonate. Which disturbance is this?

1. AMetabolic acidosis
2. BRespiratory acidosis
3. CMetabolic alkalosis
4. DRespiratory alkalosis

During CPR for asystole, when should adrenaline (epinephrine) be given according to standard adult guidelines?

1. AOnly once the patient has a pulse again
2. BAs soon as IV or IO access is obtained, then every 3–5 minutes
3. COnly after three shocks have been delivered by the defibrillator
4. DNever, because asystole is not treated with drugs

How is orthostatic (postural) hypotension usually assessed?

1. ABP lying after rest, then again after 1 and 3 minutes standing
2. BBP once sitting, then once lying down straight after a large meal
3. CBP only standing, after a brisk walk along the corridor
4. DBP in both arms at the same moment while sitting

A healthcare assistant (unlicensed assistive personnel) reports four observations. Which one needs the nurse's attention first?

1. AA patient with COPD whose SpO₂ is 90% on 1 L/min, which is usual for him
2. BA patient with heart failure who is newly confused, with SpO₂ 89%
3. CA patient after a PCI asking for a cup of tea
4. DA patient with a DVT whose leg is less swollen today

Before surgery for a phaeochromocytoma, why is an alpha-blocker started before any beta-blocker?

1. AAlpha-blockers lower the blood glucose before surgery
2. BThe order of the two drugs makes no difference
3. CA beta-blocker alone can cause a dangerous rise in BP
4. DBeta-blockers given first would make the tumour grow faster

Lúc 03:00 đường huyết của bệnh nhân là 3,6 mmol/L, nhưng trước bữa sáng thì cao. Họ tiêm insulin tác dụng kéo dài vào buổi tối. Điều dưỡng nên làm gì?

1. ABỏ qua kết quả ban đêm và chỉ xử trí theo giá trị buổi sáng
2. BCho thêm insulin lúc 03:00 vì giá trị buổi sáng sẽ cao
3. CĐiều trị đường huyết thấp và báo kiểu hình này để xem lại liều buổi tối
4. DNgừng mọi insulin vĩnh viễn và theo dõi đường huyết mỗi bốn giờ

Which practice is correct when giving parenteral nutrition through a central line?

1. AGive other IV drugs through the same lumen to save time
2. BDisconnect and reconnect the line without cleaning the hub
3. CLet the bag hang at room temperature for several days
4. DUse a dedicated lumen and strict aseptic technique

A patient with cirrhosis takes spironolactone and furosemide. Which blood result should the nurse report before the next dose?

1. ASodium 141 mmol/L
2. BSodium 138 mmol/L
3. CPotassium 6,0 mmol/L
4. DPotassium 4,2 mmol/L