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

Một điều dưỡng nhờ phụ tá điều dưỡng dùng thiết bị nâng cơ học. Phụ tá nói chưa từng được đào tạo dùng thiết bị này. Điều "đúng" nào của ủy quyền sẽ bị vi phạm nếu điều dưỡng cứ khăng khăng?

1. AĐúng giám sát và đánh giá
2. BĐúng nhiệm vụ
3. CĐúng hướng dẫn và giao tiếp
4. DĐúng người

Two days after starting haloperidol, a patient suddenly develops painful neck twisting and the eyes roll upwards. What should the nurse anticipate?

1. AA higher dose of haloperidol to calm the patient and stop the movements quickly
2. BPhysical restraint until the spasm passes
3. CNo action, because the spasm is a sign of improvement
4. DAn anticholinergic drug, such as benztropine or procyclidine, as prescribed

Which drugs are used as antidotes for nerve agent poisoning?

1. AAcetylcysteine and charcoal
2. BAtropine and pralidoxime
3. CNaloxone and flumazenil
4. DVitamin K and protamine

A patient dies after a wrong-drug error, and the hospital carries out a root cause analysis. What is its main focus?

1. ADeciding whether to tell the family about the error
2. BIdentifying which staff member made the error and should be disciplined
3. CEstimating the legal costs for the hospital
4. DFinding the system and process weaknesses that allowed the error

A patient takes low-dose methotrexate weekly for rheumatoid arthritis. Which laboratory tests are monitored regularly?

1. ASerum amylase, lipase and blood ketones
2. BTroponin, creatine kinase and myoglobin
3. CSerum lithium, sodium and urine specific gravity
4. DComplete blood count, liver tests and kidney function

A patient with long-term heavy alcohol use is admitted with alcohol withdrawal. Which group of electrolyte problems is most common?

1. ALow magnesium, low phosphate and low potassium
2. BHigh sodium, high calcium and high glucose
3. CLow chloride, high bicarbonate and high calcium
4. DHigh magnesium, high phosphate and high potassium

Which lifestyle advice helps a patient with gastro-oesophageal reflux disease?

1. AWear tight belts to support the stomach
2. BEat one very large meal a day rather than several small ones
3. CAvoid large meals late in the evening and raise the head of the bed
4. DLie down straight after each meal to let the food settle

A patient with a confirmed pulmonary embolism is started on anticoagulation. Which statement best explains its purpose?

1. AIt thins the blood so that the lungs absorb more oxygen
2. BIt stops the clot growing and prevents new clots while the body breaks it down
3. CIt is mainly given to lower the blood pressure
4. DIt dissolves the clot completely within minutes of the first dose being given

Why is a beta-blocker started at a low dose and increased slowly in heart failure?

1. AIt must be stopped as soon as symptoms improve
2. BIt can briefly worsen symptoms before long-term benefit appears
3. CIt works only if the dose is never changed after the first day
4. DIt is safe only at the highest possible dose from the very start

Một bệnh nhân đau ngực có ST chênh lên ở chuyển đạo II, III và aVF. Huyết áp 86/54 mmHg, phổi trong và tĩnh mạch cổ căng. Điều dưỡng nên đặt câu hỏi về thuốc nào đã được kê?

1. AOxy nếu SpO₂ xuống dưới mục tiêu
2. BThuốc chống nôn tĩnh mạch
3. CAspirin 300 mg nhai
4. DGlyceryl trinitrate ngậm dưới lưỡi

Why is an ACE inhibitor often given to a patient with diabetes and albumin in the urine?

1. AIt protects the kidneys and reduces albumin loss
2. BIt lowers the blood glucose to normal
3. CIt raises potassium to protect the heart
4. DIt stops the kidneys from passing so much urine at night

A prescription reads "Insulin 10U". Why is this a safety problem?

1. A"U" means the insulin must be given intravenously
2. B"U" can be misread as a zero, giving a tenfold dose
3. CThere is no problem as long as the nurse can read it
4. DInsulin doses must always be written in millilitres

What are anticipatory ("just in case") medicines at the end of life usually prescribed for?

1. AHigh blood pressure, high cholesterol and diabetes
2. BPain, nausea, agitation and respiratory secretions
3. CWeight gain and appetite stimulation
4. DInfection prevention and vaccination

A patient with a sacral pressure ulcer keeps sliding down the bed when the head is raised high. Which advice best reduces shear?

1. ASit the patient upright without any support for the feet
2. BUse a dry sheet and drag the patient up the bed
3. CRaise the head of the bed to 90° and pull the patient up the bed by the arms
4. DKeep the head of the bed at or below 30° if possible; use slide sheets