تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A nurse teaches a patient who uses home oxygen. Which statement shows a need for further teaching?

1. A“My husband can smoke in my room if the window is open.”
2. B“I will keep the oxygen away from the gas stove.”
3. C“I will put up no-smoking signs at the front door and in my room.”
4. D“I will not use oil-based creams on my face.”

Weeks after a kidney transplant, a patient has a fever, less urine and tenderness over the new kidney. What should the nurse suspect?

1. ADehydration from drinking too much
2. BRejection of the transplant
3. CA side effect of eating salty food
4. DNormal healing of the transplant

مريض يُشتبه في إصابته بالسل في غرفة ذات ضغط سلبي. أيّ ممارسة صحيحة؟

1. Aإبقاء الباب مغلقًا إلا عند الدخول أو الخروج
2. Bالسماح للزوار بالدخول دون أي حماية
3. Cإبقاء الباب مفتوحًا ليتمكن العاملون من رؤية المريض في كل وقت
4. Dإيقاف تهوية الغرفة ليلًا

A nurse has worked three long shifts in a row and feels exhausted. The manager asks the nurse to stay for another shift. What is the most appropriate response?

1. AExplain that fatigue would make care unsafe and decline the extra shift
2. BAgree, but skip the independent medication checks to save energy on the shift
3. CAgree without telling anyone about the fatigue
4. DAgree and drink extra coffee to stay alert

A nurse has a needlestick injury from a patient with unknown HIV status. Which test is usually done for the nurse as soon as possible?

1. AA sweat chloride test
2. BA baseline HIV test
3. CA thyroid panel test
4. DA serum lipase test

A patient has marked generalized edema. Results show heavy proteinuria, serum albumin 1,8 g/dL (18 g/L) and total cholesterol 340 mg/dL (8,8 mmol/L). Which condition fits best?

1. AAcute pyelonephritis
2. BPrerenal kidney injury
3. CNephrotic syndrome
4. DLiver cirrhosis only

A confused patient keeps trying to climb out of bed. Why are bed rails not automatically the answer?

1. APatients can be seriously injured climbing over or becoming trapped in rails
2. BBed rails stop staff from taking observations
3. CBed rails always make patients more confused, but only during the day
4. DBed rails are illegal in all hospitals and must never be used at all

A patient has a full-thickness burn all the way round the forearm. Which complication must be watched for closely?

1. ADelayed hair growth on the arm
2. BExcessive bleeding from the burn surface needing an urgent blood transfusion
3. CHypoglycaemia caused by the body using glucose to heal the burn
4. DLoss of circulation to the hand as swelling builds under tight burned skin

The telemetry monitor suddenly shows a chaotic waveform resembling ventricular fibrillation, but the patient is talking and brushing their teeth. What should the nurse do first?

1. ADeliver an immediate defibrillation shock before checking anything
2. BStart chest compressions straight away and call the arrest team
3. CCheck the patient and the electrodes, as this is likely artefact
4. DGive IV amiodarone as a bolus

A ventilated patient with severe ARDS is to be turned prone. What is the main reason, and the key nursing risk?

1. AIt improves oxygenation; risks are pressure injury and tube displacement
2. BIt lowers the blood pressure; the main risk is rebound hypertension
3. CIt treats infection; the risk is fever
4. DIt improves digestion and gut motility; the main risk is constipation

After transsphenoidal pituitary surgery, which advice should the patient follow?

1. AAvoid blowing the nose, straining and bending forward
2. BLie completely flat for at least a week after surgery
3. CDrink through a straw to keep the nose clean
4. DBlow the nose often to clear any clots

A 66-year-old smoker has had two episodes of painless red urine. Urine cultures are negative. Which plan is most appropriate?

1. AAnother course of antibiotics for a UTI
2. BAdvise more fluids and review in a year
3. CReassure him, because the blood has stopped
4. DUrgent referral for cystoscopy and imaging

لماذا يزداد خطر النزف لدى مرضى التشمع؟

1. Aلأن ارتفاع ضغط الدم الشرياني في التشمع يجعل الأوعية تنفجر
2. Bلأن التشمع يرفع عدد الصفيحات مما يجعلها أضعف
3. Cلأن الكبد المتندب يطلق مواد مضادة للتخثر مثل الهيبارين في الدم
4. Dلقلة عوامل التخثر وانخفاض الصفيحات ودوالي ارتفاع ضغط الباب

A patient with a platelet count of 8 × 10⁹/L (8,000/µL) develops a sudden severe headache and confusion. What should the nurse suspect?

1. ADehydration from poor intake
2. BA tension headache from stress
3. CIntracranial bleeding
4. DNormal effects of chemotherapy