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

A patient with schizophrenia says voices are telling him to hurt his roommate. What is the priority?

1. AKeep everyone safe and tell the team, as the risk of harm is high
2. BTell him the voices are not real and leave him alone
3. CAsk the roommate to stay in the room with him and help calm him down
4. DIgnore the comment, because voices are part of his illness

A patient with anorexia nervosa is admitted. Which finding is the priority?

1. ASays she feels fat although she is very thin
2. BHas fine, downy hair on her arms
3. CRefuses to eat in front of other people
4. DHeart rate 38/min and potassium 2,8 mEq/L

Which technique is used for suctioning a tracheostomy in hospital?

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

Một trẻ bị thủy đậu nhập viện. Nhân viên nào là lựa chọn tốt nhất để chăm sóc trẻ?

1. AĐiều dưỡng chưa từng bị thủy đậu hoặc chưa tiêm vắc-xin
2. BĐiều dưỡng đang mang thai và không chắc về miễn dịch của mình
3. CĐiều dưỡng có miễn dịch với thủy đậu được ghi nhận
4. DĐiều dưỡng thực tập chưa rõ miễn dịch

Một người bệnh dùng warfarin cho rung nhĩ có INR 1,4. Điều này có nghĩa là gì?

1. ANgười bệnh có nguy cơ chảy máu cao và cần vitamin K ngay
2. BLiều hoàn toàn đúng và không cần thay đổi
3. CNgười bệnh không cần dùng warfarin nữa
4. DMức chống đông dưới mục tiêu, nên dễ hình thành cục máu đông và đột quỵ hơn

A patient with a large, fast-growing lymphoma will start chemotherapy tomorrow. Which plan best prevents tumor lysis syndrome?

1. AFluid restriction and a high-potassium diet before the treatment
2. BNo special measures, because the risk starts only after a week
3. CCalcium supplements and a high-phosphate diet during treatment
4. DIV hydration, a uric acid-lowering drug and frequent electrolytes

A patient with dysphagia after a stroke has been cleared for a modified diet. How should they be positioned for meals?

1. ALying on their side with the knees bent
2. BSitting fully upright, and staying upright for a time after eating
3. CLying flat on their back with the head turned to one side
4. DSemi-reclined at about 20 degrees, with the head supported on pillows

An older patient has fallen several times since starting a new medicine. Which drug group is most likely to contribute?

1. ALubricating eye drops
2. BVitamin D supplements
3. CEmollient creams applied to the legs
4. DBenzodiazepine sleeping tablets

A 70 kg patient has passed 20 mL of urine per hour for the last three hours. How should this be interpreted?

1. ABelow 0,5 mL/kg/h, suggesting poor kidney perfusion
2. BHigh, suggesting fluid overload that needs a diuretic
3. CNormal, because the target is 0,1 mL/kg/h
4. DNormal, because any measurable urine output is reassuring

On day 2 after a surgical tracheostomy, the tube falls out. The patient is breathing but distressed. What should the nurse do first?

1. ACover the stoma completely with a sealed dressing and wait for help
2. BForce the tube back through the stoma immediately with firm pressure
3. CLeave the patient alone while fetching a new tube
4. DCall for expert help and give oxygen to both the face and the stoma

Why is levodopa combined with carbidopa (or benserazide)?

1. ATo make levodopa cross into the brain more slowly and evenly
2. BTo stop levodopa being converted to dopamine outside the brain
3. CTo prevent tolerance from developing to levodopa over time
4. DTo add a separate effect that reduces the resting tremor directly

A 66-year-old smoker has had two episodes of painless red urine. Urine cultures are negative. Which plan is most appropriate?

1. AReassure him, because the blood has stopped
2. BUrgent referral for cystoscopy and imaging
3. CAnother course of antibiotics for a UTI
4. DAdvise more fluids and review in a year

When is cold therapy most useful for pain?

1. AOver numb areas where sensation is lost
2. BSoon after an acute soft tissue injury, to reduce swelling
3. CDirectly on skin with poor circulation
4. DFor long-term muscle stiffness, applied continuously for several hours

A nurse teaches a patient after a laparoscopic fundoplication for reflux. Which statement shows a need for further teaching?

1. A"Some difficulty swallowing can happen in the early weeks."
2. B"Fizzy drinks will help me bring up wind after meals."
3. C"I'll eat soft, moist food at first and chew it well."
4. D"I should eat smaller meals for a while after the operation."