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

A patient receiving chemotherapy has a temperature of 38,3 °C and a very low neutrophil count. What should the nurse do?

1. AGive a cool shower and offer extra fluids, then wait and see what happens
2. BRecheck the temperature in four hours before telling anyone
3. CDocument the reading and mention it at the next handover
4. DReport it at once, because cultures and antibiotics are needed quickly

A dehydrated child is to receive IV fluids with added potassium. Which finding should the nurse confirm first?

1. AThat the child’s temperature is normal
2. BThat the child is passing urine
3. CThat the child can walk without help
4. DThat the child is hungry

A patient has patient-controlled analgesia (PCA). A family member presses the button while the patient sleeps. What should the nurse explain?

1. APressing it while the patient sleeps prevents the pain from getting worse later
2. BOnly the patient should press it, because this keeps the system safe
3. CThe pump will always stop any overdose
4. DFamily can press it as long as they count the presses

Khi đặt ống thông tiểu bằng kỹ thuật vô khuẩn, đầu ống thông chạm vào đùi bệnh nhân. Điều dưỡng nên làm gì?

1. ALau đầu ống bằng chất sát khuẩn và tiếp tục
2. BTráng đầu ống bằng nước vô khuẩn rồi tiếp tục
3. CBỏ ống thông và dùng ống vô khuẩn mới
4. DTiếp tục, vì đùi đã được làm sạch

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

An older adult with type 2 diabetes is drowsy and very dehydrated. Glucose 920 mg/dL (51 mmol/L), serum osmolality 350 mOsm/kg, pH 7,36, urine ketones negative or trace. Which condition fits best?

1. ASyndrome of inappropriate ADH (SIADH)
2. BMetformin-related lactic acidosis
3. CHyperosmolar hyperglycemic state (HHS)
4. DDiabetic ketoacidosis (DKA)

Why is blood pressure monitored closely in a patient with an epidural infusion?

1. AEpidurals always cause severe hypertension that needs regular treatment
2. BThe epidural pump uses the blood pressure to set the rate
3. CThe local anaesthetic can block sympathetic nerves and cause hypotension
4. DBlood pressure readings show whether the catheter is infected

An older patient has fallen several times since starting a new medicine. Which drug group is most likely to contribute?

1. AEmollient creams applied to the legs
2. BBenzodiazepine sleeping tablets
3. CLubricating eye drops
4. DVitamin D supplements

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

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

A fit 24-year-old marathon runner has a resting heart rate of 46/min on admission for minor surgery. He has no dizziness, chest pain or breathlessness, and his BP is 118/70 mmHg. What is the appropriate response?

1. ADocument and report it, as this is often normal in an athlete
2. BCancel the surgery and arrange a permanent pacemaker urgently
3. CStart chest compressions
4. DGive IV atropine straight away to bring the rate above 60/min

A woman who takes the combined contraceptive pill is starting carbamazepine. What should she be taught?

1. AThe pill makes carbamazepine toxic, so she must stop the pill
2. BShe should take both at the same time so they are absorbed together
3. CThere is no interaction between these two medicines
4. DCarbamazepine can make the pill less effective, so other contraception is needed

A man with chronic urinary retention is catheterised. Over the next hours he passes very large volumes of urine. What is the main nursing concern?

1. AFluid and electrolyte loss from post-obstructive diuresis
2. BA rise in blood glucose from the urine
3. CRupture of the bladder from the catheter
4. DA urinary infection caused by the high flow of urine

Why is the Lund and Browder chart preferred to the rule of nines for children?

1. AIt is faster to use than any other method of estimation
2. BIt adjusts for body proportions that change with age
3. CIt is used only for burns of the hands
4. DIt counts superficial burns as well

Xử trí nào nhìn chung được khuyến cáo cho vảy hoại tử đen khô, ổn định, còn nguyên ở gót chân bệnh nhân tuần hoàn kém?

1. AĐể nguyên, giảm tì đè lên gót và chuyển đánh giá
2. BCắt lọc bằng dụng cụ sắc tại giường ngay hôm nay
3. CPhủ bằng băng ép chặt
4. DNgâm nước mỗi ngày để làm mềm