أسئلة تدريبية على نمط NCLEX-PN (LPN/LVN): حزمة المراجعة المكثفة

What makes "Risk for falls" a risk nursing diagnosis rather than an actual one?

1. AThe doctor has confirmed the diagnosis with tests and a scan
2. BThe patient has already fallen several times
3. CThe problem can never be prevented
4. DThe fall has not happened yet, but risk factors are present

Which statement about the use of physical restraint is correct?

1. AIt is a last resort, uses the least restrictive option and needs regular checks
2. BIt never needs to be documented if it is used only overnight
3. CIt is the best way to stop older patients from falling
4. DIt can be used whenever a patient is confused, without further assessment

Which room lighting is safest at night for a patient at high risk of falls?

1. AComplete darkness so the patient sleeps more deeply
2. BOnly the light from the television screen
3. CBright overhead lights left on all night in the room
4. DA low night light that lights the path to the bathroom

A patient’s white cell differential shows a raised number of band (immature) neutrophils, called a “shift to the left”. What does this usually suggest?

1. AA long-standing parasitic infection
2. BAn allergic reaction
3. CA typical viral infection
4. DAn acute bacterial infection

A patient’s peripheral IV site is swollen, pale and cool, and the infusion has slowed. What should the nurse do first?

1. AStop the infusion and remove the cannula
2. BFlush the cannula hard to clear the blockage
3. CIncrease the infusion rate to overcome the resistance
4. DApply a tight bandage over the site to reduce swelling

A patient with MRSA in a wound is on contact precautions. Which instruction to the nursing assistant is correct?

1. AOnly wear gloves when touching the wound itself; skin and bedding are safe
2. BWear a gown and gloves for contact with the patient or the room, and use dedicated equipment
3. CNo special precautions are needed if the wound is covered with a dressing
4. DWear a respirator mask in the room, because MRSA in a wound spreads through the air to others

Why can a very low serum albumin contribute to oedema?

1. AIt lowers the oncotic pressure that holds fluid in the blood vessels
2. BIt makes the kidneys retain potassium
3. CIt raises the blood pressure in the capillaries and pushes fluid out
4. DIt increases the number of red cells

مريض بعد جراحة بطنية لم يتبول منذ ثماني ساعات، ولديه انزعاج في أسفل البطن ومثانة مجسوسة. ما المشكلة الأرجح؟

1. Aجفاف فقط
2. Bاحتباس البول الحاد
3. Cعدوى المسالك البولية دون احتباس
4. Dإصابة كلوية حادة دون إنتاج للبول

A patient takes low-dose methotrexate weekly for rheumatoid arthritis. Which laboratory tests are monitored regularly?

1. ASerum lithium, sodium and urine specific gravity
2. BComplete blood count, liver tests and kidney function
3. CTroponin, creatine kinase and myoglobin
4. DSerum amylase, lipase and blood ketones

A patient with severe hypertriglyceridemia has a measured sodium of 128 mEq/L, but a measured serum osmolality is normal, and the patient has no symptoms. What is the most likely explanation?

1. ATrue hyponatremia from SIADH that needs fluid restriction
2. BHyponatremia caused by severe hyperglycemia in diabetes
3. CHyponatremia caused by drinking far too much water
4. DPseudohyponatremia, an artifact caused by very high lipids

A patient must mix regular (soluble) insulin and NPH (isophane) insulin in one syringe. What is the correct order?

1. AShake both vials hard, then draw them up in any order
2. BDraw up the cloudy NPH insulin first, then the clear regular insulin
3. CDraw up the clear regular insulin first, then the cloudy NPH insulin
4. DDraw them up in separate syringes, then mix them in a cup

قد يصاب حديثو الولادة الذين يُعطَون الكلورامفينيكول بـ«متلازمة الطفل الرمادي». ما السبب الرئيسي؟

1. Aيتحول الكلورامفينيكول إلى فيتامين K لدى الولدان
2. Bعدم نضج الغلوكورونة في الكبد يسمح بتراكم الدواء
3. Cكلية الوليد تطرح الدواء بسرعة كبيرة، لذا تُعطى جرعات أعلى
4. Dينتج حديثو الولادة أضدادًا ضد الدواء

After an acute coronary syndrome, a patient with a normal cholesterol level is prescribed a high-intensity statin. Why?

1. AStatins are given after an ACS mainly to lower the blood pressure
2. BStatins work as painkillers for chest pain
3. CStatins are needed only if the cholesterol level is very high
4. DStatins reduce further events whatever the starting cholesterol

Four hours after cardiac surgery, the mediastinal drain, which had been draining steadily, suddenly stops. BP falls to 84/60 mmHg, the heart rate rises and the CVP climbs. What should the nurse suspect?

1. ANormal recovery, as the bleeding has stopped
2. BA tension pneumothorax on the left side
3. CCardiac tamponade from a clotted drain
4. DFluid overload from intravenous fluids

Before a haemodialysis catheter is used, why is the lock solution withdrawn from each lumen?

1. AIt contains air that keeps the line open
2. BIt contains concentrated anticoagulant
3. CIt contains a strong antibiotic that must be kept
4. DIt contains the patient's urine

A drowsy patient's glucose meter shows "HI". What should the nurse do?

1. ATreat it as very high, check ketones and escalate
2. BRecord "normal" in the notes because no number appears
3. CAssume the meter is broken and recheck tomorrow
4. DGive glucose gel in case the reading is wrong

Which lung problem is a known toxicity of bleomycin?

1. AAsthma from pollen
2. BPulmonary fibrosis
3. CPneumothorax from coughing
4. DLung cancer within weeks

A nurse teaches a carer about overnight tube feeding at home. Which statement shows a need for further teaching?

1. A"I'll let him lie flat so he sleeps better while the feed runs."
2. B"I'll flush the tube with water before and after his medicines."
3. C"I'll stop the feed and call if he coughs or struggles to breathe."
4. D"I'll check the external length mark on the tube every day."

Which substance in amniotic fluid is used to judge fetal lung maturity?

1. ABilirubin, assessed by its colour
2. BSurfactant, assessed by the lecithin/sphingomyelin (L/S) ratio
3. CGlucose, assessed by its concentration
4. DAlpha-fetoprotein, assessed by its level

A woman has been breastfeeding for 3 weeks. Her baby has gained little weight, feeds briefly and falls asleep at the breast. What is the most appropriate first action?

1. AObserve a full feed to assess latch and milk transfer
2. BReassure her that slow weight gain is normal
3. CAdvise her to stop breastfeeding and use formula only
4. DTell her to feed only every 6 hours to build hunger

أي علامة في منحنى النمو لطفل عمره 10 أشهر يحتاج أكثر إلى مزيد من التقييم؟

1. Aوزن انخفض عبر خطّي مئين رئيسيين منذ الزيارات الأخيرة
2. Bطول عند المئين 50 ووزن عند المئين 40
3. Cمحيط رأس يتبع منحنى المئين 75
4. Dوزن بقي عند المئين 10 منذ الولادة

A 12-year-old with asthma has been prescribed a preventer inhaler (inhaled corticosteroid) to take every day. Which statement shows a need for further teaching?

1. A"I use my spacer with my inhaler, even at school."
2. B"I rinse my mouth after using my preventer inhaler."
3. C"I carry my reliever inhaler with me everywhere I go."
4. D"I stop taking my preventer inhaler whenever I've had a few good days."

Which item is part of a safety plan for a person experiencing domestic violence?

1. ATelling the abuser about plans to leave so that he can prepare
2. BKeeping an emergency bag with documents, money and keys somewhere safe
3. CKeeping all important documents in the shared house
4. DAvoiding contact with friends and support services so as not to provoke him

For the last 3 years a man has had frequent periods of mildly raised mood and periods of low mood. None has been severe enough to count as hypomania or a major depressive episode. Which diagnosis fits best?

1. ABipolar I disorder
2. BBipolar II disorder
3. CMajor depressive disorder
4. DCyclothymic disorder

تمرين تدريبي (قيم مختلَقة، ليست إرشادات سريرية). سُجّلت جرعة عند 11:50 PM. أي إدخال هو الوقت نفسه بنظام 24 ساعة؟ انقر عليه.

1. 100:50
2. 222:50
3. 311:50
4. 423:50

تمرين تدريبي (قيم مختلَقة، ليست إرشادات سريرية). خلال المناوبة يتناول المريض ¾ كوب من شاي, 3 tsp من شراب السعال, ½ tbsp من مكمّل سائل. باستخدام المعادلات المعطاة، أوجد إجمالي المأخوذ الفموي V بالميلليترات.

يزن مريض 12 kg ووُصفت له 20 mg/kg جرعةً واحدة. أوجد الجرعة D بوحدة mg.

مريض وزنه 105,6 lb. الوصفة 2 mg/kg جرعةً واحدة، ويحتوي المخزون على 100 mg في 1 mL. باستخدام 1 kg = 2,2 lb، ما الحجم V الذي تعطيه؟

وُصف تسريب بمعدّل 60 mL/h، لكن لا تتوفّر مضخة. يجري بالجاذبية عبر طقم تسريب معامله 15 gtt/mL. أوجد معدّل التنقيط R بالقطرات في الدقيقة.

يجري تنقيط بمعدل 28 قطرة/دقيقة عبر طقم 15 قطرة/mL. بقي في الكيس 450 mL. بعد كم ساعة t سيفرغ؟ قرّب إلى منزلة عشرية واحدة.

تمرين تدريبي (قيم مختلَقة، ليست إرشادات سريرية). يبيّن السجل مدخول مريض ومخرَجه لمناوبة واحدة مدتها 12 ساعات. جرى التسريب الوريدي بالمعدل المبيَّن طوال المناوبة. أوجد المدخول الكلي I بالـ mL.

تمرين تدريبي (قيم مختلَقة، ليست إرشادات سريرية). كيس 1000 mL يجري بالمضخة بمعدل 100 mL/h. عند الساعة 21:30، كان قد سُرِّب 300 mL. كم ساعة t حتى يفرغ الكيس؟ قرّب إلى منزلة عشرية واحدة.

تمرين تدريبي (قيم مختلَقة، ليست إرشادات سريرية). مريض تدريبي بعد إصابة في الرأس يفتح عينيه عند مخاطبته، وينطق كلمات عشوائية غير مناسبة، ويُظهر كأفضل استجابة حركية: يحرّك يدًا إلى موضع الضغط (يحدّد الموضع). احسب GCS وصنّف إصابة الرأس بحسبه. انقر على إجابتك.

1. 1خفيف
2. 2متوسط
3. 3شديد

تمرين تدريبي (قيم مختلَقة، ليست إرشادات سريرية). يهدف الفريق إلى متوسط ضغط شرياني لا يقل عن 65 mmHg. الضغط الانقباضي لمريض 121 mmHg. باستخدام MAP = (SBP + 2·DBP)/3، ما أدنى ضغط انبساطي DBP يظل يعطي MAP قدره 65 mmHg؟