تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A pregnant nurse is on the unit. Which patient should the charge nurse avoid assigning to her?

1. AA patient with a fractured wrist
2. BA patient after a hip replacement
3. CA patient with type 2 diabetes who needs insulin teaching before discharge
4. DA patient with a sealed radioactive implant for cervical cancer

A patient has central chest pain that started 30 minutes ago at rest and has not eased with rest or nitroglycerin. What does this suggest?

1. AStable angina that will pass without treatment
2. BA possible myocardial infarction that needs urgent action
3. CMuscle strain that needs a warm compress
4. DIndigestion that is best treated with an antacid and a glass of milk

How does a nurse add a sterile gauze pack to a sterile field that is already set up?

1. AReach across the field with clean gloves to place the item
2. BOpen the wrapper away from the field and drop the item on it without reaching over
3. CTip the item onto the field and push it into place with the wrapper
4. DPlace the whole wrapped pack on the field and open it there with sterile gloves

A competent patient at high risk of falls insists on walking to the bathroom alone. What is the best nursing approach?

1. AExplain the risks, agree on ways to reduce them, respect the decision and document
2. BRemove the patient’s shoes and walking aid so that they cannot walk alone
3. CApply wrist restraints so the patient stays in bed
4. DTell the patient that walking alone is against hospital law

When several samples are drawn at the same venipuncture, which tubes or bottles are filled first?

1. ABlood culture bottles
2. BFluoride (glucose) tubes
3. CEDTA (complete blood count) tubes
4. DCoagulation (citrate) tubes

At the start of a shift, the nurse reviews four new results. Which patient needs attention first?

1. ASodium 119 mEq/L in a patient with new confusion and vomiting
2. BPotassium 5,2 mEq/L in a patient with stable chronic kidney disease
3. CGlucose 180 mg/dL (10 mmol/L) after a meal in a patient with diabetes
4. DHemoglobin 11,0 g/dL (110 g/L) in a patient with rheumatoid arthritis

ما الذي ينبغي عادة أن يحدّ منه مريض الكلى المزمن في نظامه الغذائي؟

1. Aالبوتاسيوم والفوسفات
2. Bفيتامين C والألياف
3. Cالكربوهيدرات تمامًا
4. Dالفيتامينات الذائبة في الماء فقط

A patient with metastatic breast cancer is confused and constipated, with a corrected calcium of 3,3 mmol/L (about 13,2 mg/dL). What is usually the first treatment?

1. AStrict fluid restriction to protect the kidneys
2. BOral calcium supplements and vitamin D
3. CA high-calcium diet
4. DIV fluid rehydration, followed by a bisphosphonate

Unless fluids are restricted, why are patients with pneumonia encouraged to drink plenty?

1. ATo flush the bacteria out through the urine
2. BTo lower the temperature by diluting the blood plasma
3. CTo prevent dehydration and keep secretions thinner
4. DTo make the cough completely stop

A patient with a confirmed type A aortic dissection is hypertensive and tachycardic while awaiting surgery. Which drug class is usually given first to lower the heart rate and blood pressure?

1. AAn intravenous thrombolytic
2. BAn intravenous fluid bolus
3. CAn intravenous beta-blocker
4. DOral aspirin

A bladder scan straight after voiding shows 450 mL of urine still in the bladder. What does this show?

1. AThe kidneys are making too little urine
2. BThe patient is passing urine normally
3. CThe patient has drunk too little fluid
4. DThe bladder is not emptying properly

After a stroke, a patient suddenly cries or laughs at odd moments. They say they do not feel sad. Which response is most appropriate?

1. ATell the patient that crying will slow their recovery
2. BAsk the doctor for a sedative to stop the outbursts
3. CExplain that this is emotional lability after stroke and help the family understand
4. DIgnore it, because it shows that the patient is seeking attention from the staff

Which statement about moist wound healing is correct?

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

في اليوم الثالث بعد جراحة الورك، يصاب مسنّ بتشوش حاد مع تذبذب الانتباه وهياج. ماذا ينبغي أن تفعل الممرضة أولًا؟

1. Aتقييد المريض وإعطاؤه جرعة كبيرة من مهدئ فورًا
2. Bأن تطلب من الأسرة أخذ المريض إلى المنزل ليهدأ
3. Cالبحث عن أسباب مثل نقص الأكسجة أو العدوى أو الألم أو الأدوية، والتصعيد
4. Dافتراض أنه خرف ومواصلة خطة الرعاية دون تغيير