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

A patient on a medical unit tells the nurse he has a plan to end his life and has saved tablets at home. What is the priority action?

1. AAsk him to promise he will not harm himself
2. BReassure him that things usually look better in the morning after some sleep
3. CArrange a psychiatry appointment for next week
4. DEnsure constant observation and remove anything he could use to harm himself

After cardiac surgery, a patient becomes hypotensive with distended neck veins and muffled heart sounds, and chest drain output has suddenly stopped. What should the nurse suspect?

1. AHypovolemic shock from dehydration
2. BLeft-sided heart failure
3. CA blocked urinary catheter
4. DCardiac tamponade

A patient needs to be moved up in bed and cannot help much. Which approach is safest?

1. AHave one nurse pull the patient up by the arms
2. BRaise the head of the bed fully and lift the patient up by the shoulders
3. CAsk the patient to push up with their heels alone
4. DUse a friction-reducing sheet with enough staff, with the bed flat if tolerated

Bệnh nhân nào cần phòng ngừa ngã nhất?

1. ABệnh nhân lớn tuổi, mới lú lẫn, đang dùng thuốc an thần, dáng đi không vững
2. BBệnh nhân chờ xuất viện đi lại tự lập
3. CMột người trẻ gãy ngón tay, đi vững và an toàn không cần trợ giúp
4. DBệnh nhân tỉnh táo nằm nghỉ tại giường và làm theo hướng dẫn

A patient had a total thyroidectomy yesterday. Which laboratory value is most important to monitor in the first days after surgery?

1. ASerum glucose
2. BSerum sodium
3. CSerum potassium
4. DSerum calcium

A patient has fever, chills, flank pain and costovertebral angle tenderness. Urinalysis shows many white cells and white cell casts. Which condition is most likely?

1. ASimple cystitis
2. BAcute pyelonephritis
3. CGlomerulonephritis
4. DNephrotic syndrome

A patient with COPD and known carbon dioxide retention needs a nebulised bronchodilator. How should it usually be given?

1. AOnly with the patient lying flat
2. BDriven by high-flow oxygen at 15 L/min for as long as possible
3. CDriven by compressed air, with oxygen given separately if needed
4. DWithout monitoring oxygen saturation

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

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

How do clopidogrel and ticagrelor work?

1. AThey block the platelet ADP (P2Y₁₂) receptor
2. BThey dissolve fibrin in existing clots
3. CThey inhibit the vitamin K-dependent clotting factors in the liver
4. DThey directly inhibit thrombin in the plasma

Một bệnh nhân COPD về nhà với oxy dài hạn. Điểm giáo dục nào quan trọng nhất về an toàn?

1. AKhông bao giờ hút thuốc hay để lửa trần gần oxy
2. BTăng lưu lượng lên cao khi khó thở
3. CDùng vaseline để làm dịu mũi khô
4. DCất bình dự phòng cạnh bếp nấu

A patient with migraine takes painkillers or triptans on most days and now has a headache almost every day. What is the likely problem?

1. AAn allergy to the painkillers
2. BA brain tumour, which is almost certain
3. CMedication overuse headache
4. DNormal progress of migraine

A patient on a variable rate IV insulin infusion is nil by mouth. Why is a glucose-containing IV fluid usually given alongside it?

1. ATo speed up the action of the insulin in the muscles
2. BTo stop the insulin sticking to the IV tubing
3. CTo prevent hypoglycaemia while insulin is running
4. DTo replace the potassium lost from the cells

Which statement about moist wound healing is correct?

1. AWounds heal fastest when left to dry out and form a scab
2. BA wet wound bed always prevents infection
3. CA moist, not wet, wound bed helps cells move and heal faster
4. DWounds should be soaked in water for hours every day

A patient's platelet count is 18 × 10⁹/L (18,000/µL). Which order should the nurse question?

1. AOral paracetamol for headache
2. BAn intramuscular injection
3. CA soft diet with mouthwashes
4. DDaily full blood count