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

A patient has a new plaster cast that is still drying. How should the nurse handle it?

1. AWith the palms of the hands, not the fingertips
2. BBy resting it directly on a hard surface
3. CBy covering it tightly with a plastic sheet
4. DWith the fingertips, pressing firmly to test it

After a head injury, a patient passes large amounts of very dilute urine, is thirsty and has a rising serum sodium. Which condition is most likely?

1. ASIADH
2. BAcute kidney injury with oliguria
3. CDiabetic ketoacidosis
4. DDiabetes insipidus

Trước khi tiếp cận đầu nối (hub) của catheter tĩnh mạch trung tâm, điều dưỡng nên làm gì?

1. ALau nhanh bằng gạc vô khuẩn khô
2. BChà đầu nối bằng chất sát khuẩn và để khô
3. CThổi nhẹ lên đầu nối để loại bỏ bụi
4. DKhông làm gì, vì đầu nối được bảo vệ dưới nắp vô khuẩn

A patient punches a nurse during care. The nurse is not seriously hurt. What should the nurse do?

1. AGet medical assessment and report the assault according to policy
2. BPunch the patient back in self-defense
3. CRefuse to care for any patient for the rest of the week until the patient is moved
4. DSay nothing, because violence is part of the job

A patient with type 2 diabetes has a target HbA1c below 7% (53 mmol/mol). Today's result is 7,8% (62 mmol/mol). What is the best interpretation?

1. AAverage glucose over the past months has been above the target
2. BThe result shows today's fasting glucose is above the target
3. CThe patient has had frequent episodes of severe hypoglycemia
4. DGlucose control has been excellent for the past several months

A patient with acute kidney injury after severe dehydration has a rising creatinine. Which urine findings support a prerenal cause rather than acute tubular necrosis (ATN)?

1. ARed cell casts with heavy protein loss in the urine
2. BWhite cell casts with positive nitrites on the dipstick
3. CLow urine sodium and concentrated urine with a high specific gravity
4. DHigh urine sodium and dilute urine with muddy brown granular casts

Sau phẫu thuật tuyến giáp, bệnh nhân tê râm ran quanh miệng và chuột rút. Cần nghi ngờ vấn đề điện giải nào?

1. AHạ calci máu
2. BTăng kali máu
3. CTăng natri máu
4. DTăng magnesi máu

A patient with a COPD exacerbation remains acidotic with a high PaCO₂ despite optimal medical treatment and controlled oxygen. Which treatment is usually considered next?

1. ASedation to slow the breathing
2. B15 L/min oxygen via a non-rebreathe mask
3. CNon-invasive ventilation
4. DStopping all oxygen therapy

What is the main problem in heart failure with preserved ejection fraction?

1. AA stiff ventricle that fills poorly in diastole
2. BA leaking aortic valve
3. CA blocked pulmonary artery
4. DA dilated ventricle that cannot contract strongly

An older inpatient develops sudden fever, muscle aches and a dry cough during the winter influenza season. Which plan is most appropriate?

1. AIsolate only if they develop a rash
2. BWait a week to see whether the symptoms settle before testing
3. CIsolate with droplet precautions, test and expect early antivirals
4. DLeave them in the open bay and give a course of antibiotics only

Why might a patient bleed more from the needle sites straight after haemodialysis?

1. ADialysis removes all the platelets from the blood
2. BThe fistula has been damaged and must be tied off
3. CHeparin is often used to stop the circuit from clotting
4. DDialysis raises the blood pressure sharply for several hours

A patient arrives five hours after the onset of a stroke. A CT angiogram shows a blockage of a large artery in the brain. What is the most appropriate next step?

1. ANo treatment, because the time for any reperfusion has passed
2. BUrgent referral for assessment for mechanical thrombectomy
3. CGive aspirin and plan a review on the ward tomorrow
4. DStart IV alteplase immediately without further imaging

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

1. AProton pump inhibitors
2. BNon-selective beta-blockers
3. CThiazide diuretics
4. DCalcium supplements

A patient is booked for a urea breath test for H. pylori. Which medicine should usually be stopped 2 weeks before the test?

1. AOmeprazole
2. BParacetamol (acetaminophen)
3. CLevothyroxine
4. DAmlodipine