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. ABy covering it tightly with a plastic sheet
2. BWith the palms of the hands, not the fingertips
3. CWith the fingertips, pressing firmly to test it
4. DBy resting it directly on a hard surface

A patient with anorexia nervosa is admitted. Which finding is the priority?

1. ARefuses to eat in front of other people
2. BSays she feels fat although she is very thin
3. CHeart rate 38/min and potassium 2,8 mEq/L
4. DHas fine, downy hair on her arms

A small spill of blood is found on the floor. How should it be cleaned?

1. ACover it with a clean sheet and keep working
2. BWear gloves, absorb the blood, then clean the area with an approved disinfectant
3. CLeave it until housekeeping arrives the next morning
4. DWipe it up quickly with a dry cloth using bare hands, then wash the hands well

A patient on oxygen needs an MRI scan. Which plan is safe?

1. ALeave the steel cylinder on the patient’s bed during the scan
2. BRemove the oxygen for the scan without telling anyone
3. CTake the usual steel cylinder into the room if it is tightly strapped to the trolley frame
4. DUse only MRI-safe equipment, and never take a standard steel oxygen cylinder into the scanner room

A patient's eGFR has fallen to 24 mL/min/1,73 m². Which prescribed drug should the nurse question before giving it?

1. ALevothyroxine
2. BAcetaminophen (paracetamol)
3. CInsulin glargine
4. DMetformin

Which set of results most strongly suggests hemolytic anemia?

1. ALow hemoglobin, high MCV, low vitamin B₁₂, normal bilirubin
2. BLow hemoglobin, high reticulocytes, high unconjugated bilirubin, high LDH
3. CLow hemoglobin, low platelets, low white cells, low reticulocytes
4. DLow hemoglobin, low reticulocytes, low MCV, low ferritin

A patient with leukaemia has a very low platelet count. Which nursing precaution is appropriate?

1. AUse a soft toothbrush and an electric razor
2. BTake temperatures rectally
3. CGive medicines by intramuscular injection
4. DEncourage contact sports to keep fit

A nurse phones a doctor about a deteriorating patient using SBAR. Which statement belongs in the "R" section?

1. A"He was admitted three days ago with pneumonia."
2. B"I am calling about Mr Smith, who is breathless."
3. C"His blood pressure is 85/50 and he is confused."
4. D"Please review him within the next 15 minutes."

Sau khi đặt máy tạo nhịp vĩnh viễn, hướng dẫn nào thường được đưa ra trong vài tuần đầu?

1. AGiữ cánh tay hoàn toàn bất động trong băng đeo sáu tháng trở lên
2. BTránh nâng cánh tay bên đó cao quá vai
3. CKhông tắm hay rửa gì cả trong sáu tuần
4. DXoa bóp mạnh vết thương hai lần mỗi ngày

A patient with severe aortic stenosis is prescribed glyceryl trinitrate (nitroglycerin) for chest pain. Why should the nurse use particular caution?

1. AVasodilators can cause a severe fall in BP with a fixed outflow obstruction
2. BThere is no reason for caution, because GTN acts only on the coronary arteries
3. CGTN makes the narrowed aortic valve tighten further within a few minutes
4. DGTN raises the blood pressure dangerously in aortic stenosis

A patient takes levodopa for Parkinson's disease. Which teaching point is correct?

1. AThe tablets work best taken with a large steak dinner
2. BLarge high-protein meals can reduce how well the drug works
3. CThe drug cures the disease if taken for a full year
4. DStop the drug for a day each week to avoid tolerance

Near the end of a haemodialysis session, a patient has painful leg cramps and a falling blood pressure. What is the most likely cause?

1. AAn allergic reaction to the needles
2. BNot enough fluid is being removed
3. CThe dialysate is too cold
4. DFluid is being removed too quickly

How should a patient use an incentive spirometer after surgery?

1. ABlow out as hard and as fast as possible
2. BBreathe quickly in and out ten times in a row
3. CBreathe in slowly and deeply, then hold briefly
4. DUse it once a day, just before going to sleep at night

Which new prescription for a patient with cirrhosis should the nurse question?

1. ALactulose to keep the bowels open
2. BThiamine supplements
3. CSpironolactone for ascites
4. DRegular ibuprofen for back pain