تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A patient at 35 weeks of pregnancy with high blood pressure calls the clinic. Which symptom needs urgent assessment?

1. ANeeding to pass urine more often
2. BMild ankle swelling at the end of the day
3. CA severe headache with blurred vision
4. DBackache after a long walk

An older patient with heart failure is receiving a second unit of blood. She becomes breathless, with crackles in both lungs and a rising blood pressure. What is most likely happening?

1. AHypoglycemia caused by the stored blood product
2. BA mild allergic reaction with hives
3. CAn expected effect of the first unit
4. DTransfusion-associated circulatory overload

A new antibiotic is prescribed for a patient. What should the nurse check before giving the first dose?

1. AThe patient’s allergies, by checking the record and asking the patient
2. BOnly the time of the patient’s last meal and drink
3. COnly the patient’s blood pressure and pulse before giving the drug
4. DThe patient’s preferred pharmacy

A nurse teaches parents about using an infant car seat. Which statement shows a need for further teaching?

1. A“We will install the seat in the back seat, facing the rear.”
2. B“We will use the car seat for every trip, even short ones.”
3. C“We will make sure the harness straps are snug against the baby’s chest.”
4. D“We will put the rear-facing seat in the front so we can see the baby.”

After surgery for colon cancer, a patient's CEA had fallen to normal, but it has been rising over the last two checks. What does this most likely suggest?

1. AA normal change after surgery that needs no follow-up
2. BA sure sign that the cancer has been fully cured
3. CA sign of iron deficiency from the earlier bleeding
4. DPossible recurrence that needs further assessment

A patient with acute pancreatitis has a rising BUN, a falling calcium and a glucose of 250 mg/dL (13,9 mmol/L) over the first 48 hours. What do these results suggest?

1. AIncreasingly severe pancreatitis
2. BA lab error from lipemic samples
3. CAn unrelated new kidney stone
4. DA resolving, mild pancreatitis

A nurse finds a patient lying on the floor beside the bed. What should be done first?

1. ACheck the patient for injuries before moving them
2. BLift the patient straight back into bed so they are comfortable
3. CPhone the patient's family
4. DComplete the incident report form

A patient going home after chemotherapy is taught about infection. Which statement shows a need for further teaching?

1. A"If I get a temperature, I'll take paracetamol and wait until my next clinic."
2. B"I will wash my hands well before eating and after using the toilet."
3. C"I will check my temperature if I feel unwell or shivery at home."
4. D"I will phone the helpline if I have a fever or shivering."

أيّ اختبار مخبري يُستخدم لضبط تسريب الهيبارين غير المجزّأ؟

1. AINR (النسبة المعيارية الدولية)
2. Bمستوى D-dimer
3. Cمستوى الفبرينوجين في المصل
4. Dزمن الثرومبوبلاستين الجزئي المنشَّط (أو مستوى مضاد Xa)

A 28-year-old woman taking the combined pill comes in breathless and anxious. RR is 30/min, heart rate 118/min and SpO₂ 90% on air. A colleague says it is a panic attack. What should the nurse conclude?

1. ALow oxygen saturation is not explained by anxiety; PE must be excluded
2. BThe saturation is normal for an anxious person who is breathing fast
3. CBreathing into a paper bag is the best first treatment for her
4. DShe should be sent home after a sedative

Why is IV calcium gluconate given in severe hyperkalaemia?

1. AIt binds potassium in the gut
2. BIt removes potassium through the kidneys
3. CIt moves potassium into the cells
4. DIt protects the heart from arrhythmias

A patient has erratic glucose readings. The nurse finds a soft, rubbery lump where they always inject. What is the most important teaching?

1. AUse healthy sites and check glucose often, as less insulin may be needed
2. BDouble the insulin dose because the lump blocks the insulin
3. CMassage the lump firmly after every injection
4. DKeep injecting into the lump, because it hurts less there

Which statement about pain relief in acute pancreatitis is correct?

1. AOnly paracetamol may be given
2. BOpioids must never be used in pancreatitis
3. CPain relief should be withheld until the diagnosis is certain
4. DOpioids can be used, and good analgesia is a priority

An older patient on regular opioids has small amounts of liquid stool leaking all day, but has not had a formed bowel movement for 6 days. What is the most likely cause?

1. AFaecal impaction with overflow
2. BAcute infective gastroenteritis
3. CA flare of ulcerative colitis
4. DNormal stool pattern on opioids