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

A patient with diabetes is unresponsive and has a blood glucose of 40 mg/dL (2,2 mmol/L). What should the nurse do first?

1. AWait 15 minutes and recheck the glucose
2. BPour orange juice into the patient’s mouth
3. CGive IV dextrose or glucagon as prescribed
4. DGive the scheduled dose of insulin

A charge nurse notices that a nurse smells of alcohol and is slurring words at the start of the shift. What is the priority?

1. ARemove the nurse from patient care and report it according to policy
2. BAsk the nurse to drink coffee and then start work
3. CLet the nurse work, but only with stable patients
4. DWait until the end of the shift and then discuss the concern with the nurse privately

Which practice reduces back strain when a nurse moves a patient or heavy object?

1. AHold the load at arm’s length to keep it steady
2. BStand with the feet close together for balance
3. CBend at the waist and keep both knees straight
4. DKeep the load close to the body and avoid twisting

While preparing a chemotherapy infusion, the drug splashes onto a nurse’s forearm. What should the nurse do first?

1. AWipe the skin with an alcohol swab and continue preparing the infusion
2. BRemove contaminated PPE and wash the skin with soap and water at once
3. CCover the area with a dressing and report later
4. DFinish hanging the infusion and then wash the skin

A patient had a total gastrectomy. Which long-term therapy is needed to prevent anemia?

1. ALifelong oral folic acid tablets only
2. BLifelong vitamin B₁₂ replacement
3. CWeekly doses of oral vitamin K tablets
4. DMonthly transfusions of red blood cells

Two days after bowel surgery, a patient with nasogastric suction has a distended abdomen, absent bowel sounds and muscle weakness. The potassium is 2,8 mEq/L. Which interpretation is best?

1. AThe potassium is normal for the second day after surgery
2. BThe low potassium is due to the patient drinking too much water
3. CHyperkalemia from tissue damage is causing the bowel to stop
4. DHypokalemia from gastric losses is contributing to paralytic ileus

A patient with sickle cell disease is admitted with a painful crisis. What is a key early nursing priority?

1. ADelaying pain relief until a diagnosis is confirmed
2. BApplying cold packs to the painful areas
3. CRestricting oral fluids
4. DGiving prompt, effective analgesia

Why are liquid medicines for nasogastric tubes drawn up in dedicated enteral (oral) syringes rather than IV syringes?

1. AIV syringes cannot hold liquid medicines
2. BEnteral syringes measure doses less accurately
3. CEnteral syringes keep the medicine sterile
4. DTo prevent accidental intravenous administration

Nhận định nào về buồng đệm (spacer) cho bình xịt định liều là đúng?

1. ANghĩa là có thể ngừng hẳn bình hít steroid dự phòng
2. BCần ít phối hợp hơn, và nhiều thuốc đến phổi hơn
3. CĐược thiết kế để dùng với dụng cụ hít bột khô
4. DLàm mỗi lần xịt mạnh hơn bình thường

Một bệnh nhân COPD khó thở với SpO₂ 84% khi thở khí phòng. Khí máu cho pH 7,30 và PaCO₂ tăng dù đã điều trị nội khoa tối ưu. Điều trị nào nhiều khả năng được cân nhắc?

1. AAn thần tĩnh mạch để làm chậm nhịp thở
2. BNgừng thuốc giãn phế quản khí dung
3. COxy nồng độ cao qua mặt nạ không thở lại
4. DThông khí không xâm lấn (NIV)

Một bệnh nhân suy thượng thận nguyên phát bị sốt. Lời khuyên ngày ốm thông thường cho thuốc steroid thay thế là gì?

1. AGiữ liều thường lệ và tránh uống thêm dịch lúc này
2. BNgừng steroid cho đến khi hết sốt
3. CTăng liều glucocorticoid, thường gấp đôi
4. DGiảm một nửa liều để giảm tác dụng phụ

A patient with gastroparesis has hypos soon after their meal-time insulin, then high glucose several hours later. What is the best explanation?

1. AThe patient is secretly eating sweets between meals
2. BThe insulin has gone off and needs replacing
3. CFood is absorbed slowly, so the insulin peaks before the glucose rises
4. DThe meter gives false results for several hours after every meal

Why are patients with diabetes often placed early on the operating list?

1. ATo shorten fasting and reduce swings in blood glucose
2. BBecause their wounds heal faster in the morning
3. CBecause their surgery always takes longer than others
4. DBecause they need to go home before midday

An hour after a line flush, a patient receiving parenteral nutrition has rigors and a temperature of 39,1 °C. What should the nurse suspect and do?

1. AA normal reaction; give paracetamol and continue the infusion
2. BLine infection; escalate and take blood cultures
3. CLow blood glucose; give a sugary drink
4. DFluid overload; reduce the infusion rate only