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

A nursing assistant offers to suction a patient’s new tracheostomy. Which response from the RN is best?

1. A“Thank you, please suction him as needed and tell me how it went.”
2. B“Ask the patient’s family to do the suctioning today.”
3. C“Suctioning a new tracheostomy is my task; I will do it myself.”
4. D“Leave the suctioning until the next shift arrives.”

A trauma patient has an open leg fracture, absent breath sounds on one side, a trachea shifted to the other side and a falling blood pressure. Which problem is the priority?

1. AThe pain from the fracture
2. BThe open fracture of the leg
3. CThe risk of wound infection
4. DThe suspected tension pneumothorax

A patient is receiving opioids for pain. Which sign usually comes before opioid-induced respiratory depression?

1. ADiarrhea
2. BDilated pupils
3. CIncreasing sedation
4. DRising blood pressure

A patient asks for a pain tablet. The record shows none has been given, but the patient says, “The other nurse gave me one earlier.” What should the nurse do?

1. AGive half a tablet now, to be safe, and the other half later if needed
2. BCheck with the other nurse and the records before giving another dose
3. CGive the tablet, because the record shows none was given
4. DTell the patient they must be confused

A patient with diabetes is found unconscious with a blood glucose of 38 mg/dL (2,1 mmol/L). Which treatment is appropriate?

1. AOrange juice poured slowly into the patient's mouth
2. BGlucagon by injection, or IV dextrose as prescribed
3. CA dose of rapid-acting insulin to stabilize the glucose
4. DGlucose tablets placed between the patient's teeth

A patient with acute kidney injury has a potassium of 6,8 mEq/L despite medical treatment, a pH of 7,12 and pulmonary edema not responding to diuretics. Which treatment is most likely needed?

1. AAn IV magnesium dose
2. BUrgent dialysis
3. CA potassium supplement
4. DMore oral fluid

Which tool is commonly used at the bedside to screen for delirium?

1. AThe Glasgow-Blatchford score
2. BThe Malnutrition Universal Screening Tool
3. CThe Braden scale
4. DThe Confusion Assessment Method (CAM)

A patient is taught to self-inject low-molecular-weight heparin. Which statement shows a need for further teaching?

1. A"I will change the injection site each time."
2. B"I will inject into the fatty tissue of my abdomen."
3. C"I will report any unusual bleeding or bruising."
4. D"I will rub the area firmly after the injection."

Why is active tuberculosis treated with several drugs for at least six months?

1. ATo kill slow-growing bacteria and prevent drug resistance
2. BTo reduce the number of side effects compared with one drug
3. CBecause the bacteria are resistant to all drugs at first
4. DBecause each drug works on a different organ only

A patient with rheumatoid arthritis is due to start an anti-TNF biologic drug. Which screening is essential beforehand?

1. AA sweat chloride test
2. BAn exercise ECG test on a treadmill
3. CScreening for latent tuberculosis
4. DA peak flow diary for a month

A patient takes levodopa for Parkinson's disease. Which teaching point is correct?

1. AStop the drug for a day each week to avoid tolerance
2. BThe drug cures the disease if taken for a full year
3. CLarge high-protein meals can reduce how well the drug works
4. DThe tablets work best taken with a large steak dinner

Một phụ nữ bị động kinh dùng valproate nói rằng cô đang dự định mang thai. Phản hồi nào phù hợp nhất?

1. ATrấn an rằng valproate an toàn trong suốt thai kỳ
2. BBảo cô ngừng hoàn toàn valproate từ hôm nay
3. CKhuyên không ngừng đột ngột và đánh giá chuyên khoa khẩn
4. DGợi ý tăng gấp đôi liều để bảo vệ thai khỏi co giật

Vì sao bệnh nhân được dạy ôm vết mổ bụng bằng gối khi ho?

1. AThay thế nhu cầu giảm đau đều đặn
2. BĐẩy nhanh lành các mép da
3. CGiảm đau và căng, nên họ ho tốt hơn
4. DLàm cơn ho yếu đi nên vết mổ không bị nguy cơ

Hai ngày sau khi bắt đầu hóa trị u lympho độ ác cao, lượng nước tiểu của bệnh nhân giảm; kali 6,4 mmol/L, phosphate cao và calci thấp. Điều dưỡng nên nghi ngờ gì và làm gì?

1. AHội chứng ly giải u: báo cáo lên, bắt đầu theo dõi tim và dự kiến dịch tĩnh mạch
2. BTác dụng phụ hóa trị dự kiến: không cần làm gì đến chu kỳ sau
3. CMất nước đơn thuần: khuyến khích uống dịch và kiểm tra máu lại tuần sau
4. DPhản ứng dị ứng: cho thuốc kháng histamine và tiếp tục như bình thường