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

A patient taking clozapine reports a sore throat and fever. What is the priority action?

1. AHold the dose and report so the white cell count can be checked
2. BOffer throat lozenges and continue the usual dose
3. CIncrease the dose because the symptoms suggest a relapse
4. DAdvise the patient to gargle with warm salt water and rest in bed

A patient is going home on a new oral anticoagulant. There is only a short time for teaching. Which topic is most important?

1. AWhich television programs help with relaxation
2. BHow to cook low-fat meals
3. CHow to choose comfortable walking shoes
4. DSigns of bleeding and when to seek help

A portable x-ray is taken at the bedside. Which action protects the nurse?

1. AStay close to the patient to keep them still without protection
2. BLook directly at the x-ray tube during the exposure to check its position
3. CStep away from the patient or wear a lead apron during the exposure
4. DStand next to the patient and hold the film without protection

A 2-year-old living in a house built many decades ago has anemia, irritability and poor appetite. Which cause should the nurse suspect?

1. AA food allergy to cow’s milk proteins
2. BLead poisoning from old paint dust or chips
3. CCarbon dioxide from a gas cooker
4. DIron overload from eating too much red meat

A patient with pneumonia had a CRP of 180 mg/L on admission and 40 mg/L after 4 days of antibiotics. What does this most likely show?

1. AThe infection has spread to another organ
2. BThe patient has developed a new infection
3. CThe inflammation is settling with treatment
4. DThe antibiotic is causing liver damage

A patient receiving parenteral nutrition with lipid emulsion has a triglyceride level of 620 mg/dL (7,0 mmol/L). Why is this result important?

1. AIt raises the risk of acute pancreatitis
2. BIt means the patient needs more lipid
3. CIt shows the nutrition is fully effective
4. DIt is a normal fasting value for adults

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. CRemoving hair, if needed, with clippers rather than a razor
4. DLeaving the patient cool during surgery to slow bacterial growth

An older man has sudden severe abdominal and back pain, is hypotensive and has a pulsating mass in the abdomen. What should be suspected?

1. ARenal colic from a kidney stone
2. BA ruptured abdominal aortic aneurysm
3. CAcute gastritis from anti-inflammatory drugs
4. DMusculoskeletal back pain

Phục hồi chức năng phổi trong COPD là gì?

1. AMột đợt steroid và kháng sinh đường uống dùng tại nhà mỗi mùa đông
2. BXét nghiệm chức năng phổi lặp lại mỗi sáu tháng
3. CPhẫu thuật cắt bỏ những vùng phổi tổn thương nhất
4. DTập luyện có giám sát và giáo dục giúp giảm khó thở

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. BThông khí không xâm lấn (NIV)
3. COxy nồng độ cao qua mặt nạ không thở lại
4. DNgừng thuốc giãn phế quản khí dung

A patient taking warfarin is diagnosed with an intracerebral haemorrhage. What is the priority treatment?

1. AIV thrombolysis within 4,5 hours
2. BStarting aspirin to prevent further clots
3. CDoubling the warfarin dose to stabilise the INR
4. DUrgent reversal of the anticoagulant effect

A patient received IV insulin and glucose for hyperkalaemia an hour ago. What must the nurse monitor over the next few hours?

1. AUrine colour, for blood in the urine
2. BPupils, for raised intracranial pressure
3. CCapillary glucose, for hypoglycaemia
4. DSkin, for a drug rash

A dying patient can no longer drink. Which mouth care is most appropriate?

1. AFrequent, gentle moistening of the mouth and lips
2. BNo mouth care, to avoid disturbing the patient
3. CBrushing hard with a stiff toothbrush twice a day
4. DLemon and glycerine swabs every hour to stimulate saliva

A category (stage) 4 pressure ulcer is now healing and shallower. How should it be documented according to standard guidance?

1. AAs a fully healed ulcer that can be removed from the record
2. BAs a category 2 pressure ulcer now
3. CAs a category 1 pressure ulcer now
4. DAs a healing category 4 pressure ulcer