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

Before accessing a central venous catheter, what should the nurse do to prevent infection?

1. ARinse the hub with tap water and dry it
2. BBlow on the hub to remove any dust before connecting the syringe or line
3. CTouch the hub to check it is clean
4. DScrub the hub with an antiseptic such as chlorhexidine and let it dry

A patient has a wrist restraint. The nurse finds the fingers on that hand pale, cool and tingling. What should the nurse do first?

1. ALoosen the restraint and assess the circulation
2. BTighten the restraint so the patient moves less
3. CDocument the finding and continue with the medication round
4. DRaise the arm on a pillow and check again in two hours

A nurse gives part of a dose of an opioid from a vial and must discard the rest. What is correct?

1. AReturn the rest to the patient’s medication drawer
2. BKeep the rest for the patient’s next dose
3. CDiscard it in front of a second licensed (registered) nurse, who witnesses and documents it
4. DDiscard it alone in the sink and document the amount wasted later in the shift

Why can a patient with severe neutropenia have a serious infection but little redness, swelling or pus?

1. AAntibiotics given with chemotherapy hide all signs of infection
2. BThere are too few neutrophils to produce the usual inflammatory signs
3. CChemotherapy kills the bacteria before they can multiply
4. DNeutropenia makes infections stay limited to the skin

Một người bệnh đã nôn hai ngày có BUN 32 mg/dL (urê 11,4 mmol/L) và creatinine bình thường. Nguyên nhân có khả năng nhất là gì?

1. AChế độ ăn ít protein
2. BSuy gan
3. CThừa nước
4. DMất nước

A patient with long-standing rheumatoid arthritis has a hemoglobin of 10,5 g/dL (105 g/L), a low serum iron, a low total iron-binding capacity (TIBC) and a high-normal ferritin. Which condition fits best?

1. AVitamin B₁₂ deficiency anemia
2. BAcute blood loss anemia
3. CAnemia of chronic disease (inflammation)
4. DIron-deficiency anemia

Which measure helps reduce the risk of surgical site infection?

1. AChanging the wound dressing every hour
2. BShaving the area with a razor the night before surgery
3. CLeaving the patient cool during surgery to slow bacterial growth
4. DRemoving hair, if needed, with clippers rather than a razor

Why are patients with nephrotic syndrome at increased risk of blood clots?

1. AThey lose most of their platelets in the urine every day
2. BTheir blood pressure is always very low
3. CAnticoagulant proteins are lost in the urine and clotting factors rise
4. DThey lose all their red cells in the urine, which thickens the remaining blood

A patient with heart failure starts dapagliflozin, an SGLT2 inhibitor. Which teaching is most relevant?

1. AExpect the urine to turn bright orange and stain underwear and clothes
2. BAvoid drinking any fluids at all for the first week of treatment
3. CKeep the genital area clean, as fungal infections are more common
4. DTake an extra dose if the ankles swell

Một bệnh nhân bắt đầu dùng thuốc ức chế men chuyển hôm qua xuất hiện phù môi và lưỡi và khàn giọng. Điều dưỡng nên làm gì trước tiên?

1. ACho liều tiếp theo sớm, vì như vậy sẽ làm hết phù nhanh
2. BĐánh giá đường thở, gọi hỗ trợ khẩn và giữ các liều tiếp theo
3. CGiải thích rằng đây là tác dụng phụ dự kiến, vô hại
4. DChườm đá lên môi và đánh giá lại vào buổi sáng

A patient with diabetic neuropathy has an ulcer on the ball of the foot. Which measure is most important for healing?

1. ASoaking the foot in hot water daily
2. BCovering it and checking it in a month
3. CTaking pressure off the ulcer
4. DWalking more to improve blood flow

A patient with multiple sclerosis has had worse leg weakness for one day, together with a fever and burning on passing urine. What is the most likely explanation?

1. AA pseudo-relapse caused by infection
2. BA side effect of physiotherapy
3. CA change to progressive MS
4. DA true relapse that needs high-dose steroids

Which lifestyle change most improves the course of Crohn's disease?

1. AStopping smoking
2. BAvoiding all exercise
3. CDrinking more coffee
4. DEating more red meat

Một bệnh nhân tắc ruột xuất hiện đau liên tục dữ dội (không còn từng cơn), sốt, nhịp tim 120/phút và bụng cứng, đau. Điều này gợi ý gì?

1. ATắc nghẽn đang giải quyết khi ruột bắt đầu cử động
2. BNghẹt ruột hoặc thủng cần phẫu thuật viên đánh giá khẩn
3. CTáo bón nên điều trị bằng thuốc nhuận tràng kích thích
4. DDiễn tiến bình thường chỉ cần giảm đau đơn giản đều đặn