تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A woman calls to say her husband suddenly has a drooping face and slurred speech. What should the nurse advise?

1. ALet him lie down and see if it improves
2. BBook an appointment with his doctor next week
3. CCall emergency services now and note the time it started
4. DDrive him to the hospital yourself after he has eaten dinner

After handover on a medical unit, which patient should the nurse see first?

1. ADay 2 after a hernia repair, pain 6/10, oral analgesic due in 20 minutes, wants it now
2. BNew atrial fibrillation, heart rate 150/min, blood pressure 86/50 mmHg, dizzy
3. CPneumonia on 2 L/min oxygen, SpO₂ 93%, talking in full sentences
4. DDeep vein thrombosis on a heparin infusion, aPTT in the target range

قبل الوصول إلى محور القسطرة الوريدية المركزية، ماذا ينبغي أن تفعل الممرضة؟

1. Aالنفخ برفق على المحور لإزالة الغبار
2. Bمسحه سريعًا بشاش معقم جاف
3. Cلا شيء، لأن المحور محمي بغطاء معقم
4. Dفرك المحور بمطهّر وتركه حتى يجف

Which patient with a suspected infection meets the qSOFA criteria that signal a higher risk of a poor outcome?

1. ARespiratory rate 24/min, new confusion, systolic BP 95 mmHg
2. BRespiratory rate 18/min, alert, systolic BP 130 mmHg, temperature 38,5 °C
3. CRespiratory rate 20/min, alert, systolic BP 110 mmHg, heart rate 110/min
4. DRespiratory rate 16/min, alert, systolic BP 105 mmHg, WBC 13,000/mm³

لماذا يعاني مرضى المرض الكلوي المزمن غالبًا من فقر الدم؟

1. Aتجعل سموم اليوريميا نقي العظم ينتج كريات بيضاء بدلًا من الحمراء
2. Bتصنع الكليتان كمية أقل من الإريثروبويتين الذي يحفّز إنتاج الكريات الحمراء
3. Cيحطم البوتاسيوم المرتفع في المرض الكلوي الكريات الحمراء
4. Dترشّح الكليتان التالفتان الكريات الحمراء وتدمرها

A child with sickle cell disease and a recent viral illness is pale and tired. The hemoglobin has fallen sharply, and the reticulocyte count is very low. What is the most likely problem?

1. AIron deficiency from a poor diet over months
2. BA normal finding in sickle cell disease
3. CA vaso-occlusive pain crisis in the bones
4. DAn aplastic crisis, often caused by parvovirus B19

Which statement about storing insulin is correct?

1. AInsulin should be kept in direct sunlight
2. BUnopened insulin is kept in the fridge and must not be frozen
3. CAll insulin should be stored in the freezer to keep it fresh
4. DInsulin never expires once opened

In a patient with a head injury, which is usually the earliest sign of rising intracranial pressure?

1. AIrregular breathing pauses
2. BA slow pulse with high blood pressure
3. CA change in level of consciousness
4. DA fixed, dilated pupil on both sides

A patient has just started an ACE inhibitor. Which blood tests are usually checked within the first one to two weeks?

1. APotassium and creatinine
2. BTroponin and creatine kinase
3. CLiver enzymes and amylase
4. DINR and platelet count

A patient has sudden severe chest pain spreading to the back between the shoulder blades. Which finding most supports aortic dissection rather than myocardial infarction?

1. AA large difference in blood pressure between the arms
2. BA heart rate of 104/min and a respiratory rate of 22/min
3. CPain that started at rest
4. DSweating, nausea and pallor that started with the pain

Which picture fits anterior cord syndrome?

1. ALoss of movement and pain sense, with position sense kept
2. BNormal movement but complete loss of position sense
3. CArms much weaker than legs after a neck injury
4. DWeakness on one side and loss of pain sensation on the other side

A student has fever, a severe headache, a spreading non-blanching rash and a BP of 85/50 mmHg. A lumbar puncture is planned. What is the priority?

1. AGive paracetamol (acetaminophen) and recheck observations in an hour
2. BWait until after the lumbar puncture before giving antibiotics
3. CGive IV antibiotics at once and start sepsis treatment
4. DArrange a CT scan of the head before any treatment

أيّ طور من التئام الجروح يتضمن تكوين النسيج الحبيبي وأوعية دموية جديدة؟

1. Aالطور الالتهابي
2. Bطور التكاثر
3. Cطور النضج
4. Dطور الإرقاء (التخثر)

A patient with diabetes has rapidly spreading redness around a small wound, severe pain out of proportion, fever and crackling under the skin. What should the nurse suspect?

1. AA simple insect bite
2. BA healing venous ulcer
3. CMild contact dermatitis
4. DNecrotising fasciitis