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

A patient taking an SSRI is also given tramadol. A few hours later the patient is agitated, sweating and has a fever, jerking muscles and brisk reflexes. What is the most likely cause?

1. AAn anxiety attack
2. BSerotonin syndrome
3. COpioid withdrawal
4. DNeuroleptic malignant syndrome

تنبّه مكتبة الأدوية في مضخة التسريب إلى أن الجرعة المبرمجة أعلى من الحد الآمن. ماذا ينبغي أن تفعل الممرضة؟

1. Aإعادة فحص الأمر الدوائي والحساب وإعدادات المضخة أولًا
2. Bتجاوز التنبيه، لأن تنبيهات المضخة كثيرًا ما تكون خاطئة
3. Cإيقاف مكتبة الأدوية لهذا التسريب
4. Dمواصلة التسريب وإعادة فحص المضخة في نهاية الوردية

A patient on long-term high-dose corticosteroids asks for the nasal spray influenza vaccine. What should the nurse explain?

1. APeople on steroids should never have any influenza vaccine
2. BThe nasal spray is a live vaccine, so the injected inactivated vaccine is used instead
3. CEither type is fine, as long as it is given in the morning
4. DThe nasal spray is the best choice for people on steroids, because it is not injected

Which instruction is correct for a patient starting oral iron tablets?

1. AYour stools may turn dark green or black
2. BYour urine will turn bright orange while you take it
3. CTake each tablet with milk to protect the stomach
4. DTake the tablet with an antacid to improve absorption

A patient recovering from acute tubular necrosis now passes 4–5 L of urine a day. Which electrolyte changes should the nurse watch for?

1. AHigh potassium and high sodium from retention
2. BHigh calcium and high phosphate from bone loss
3. CLow potassium and low sodium from urine losses
4. DNo changes, because the kidneys are now normal

Which technique is correct when suctioning through a tracheostomy?

1. AKeep suctioning for at least a minute each time to clear all the secretions
2. BApply suction only while withdrawing the catheter, for no more than about 10–15 seconds
3. CSuction every 15 minutes whether or not secretions are present
4. DApply suction continuously while inserting the catheter as far as it will go

يصبح مريض الربو الشديد هادئًا، مع "صدر صامت" وإنهاك وانخفاض في معدل التنفس. على ماذا يدل ذلك؟

1. Aتعافٍ طبيعي بعد جهاز الإرذاذ
2. Bربو مهدد للحياة مع توقف تنفسي وشيك
3. Cقلق فقط
4. Dتحسّن النوبة مع هدوء التشنج القصبي واسترخاء المجاري الهوائية

Which investigation is usually used to confirm a deep vein thrombosis in the leg?

1. AA plain chest X-ray and an ECG
2. BA lung function test
3. CAn exercise ECG
4. DCompression duplex ultrasound

مريض يتناول الوارفارين بسبب الرجفان الأذيني قيمة INR لديه 8,5 دون نزف. ما التدبير الأرجح؟

1. Aإعطاء مركّز معقّد البروثرومبين ونقل دم
2. Bحجب الوارفارين وإبلاغ واصف الدواء وإعادة فحص INR قريبًا
3. Cمواصلة الجرعة المعتادة وإعادة فحص INR بعد شهر
4. Dإعطاء كبريتات البروتامين وريديًا فورًا لعكسه

Which nursing action helps most to prevent and manage delirium in an older inpatient?

1. AUse glasses and hearing aids and reorient the patient often
2. BKeep the lights on all night so the patient can see clearly
3. CMove the patient to a different room each day for variety
4. DRestrain the patient so that they do not wander off the ward

A patient had a witnessed tonic-clonic seizure. Afterwards their left arm is weak, and the weakness improves over the next few hours. What is the best interpretation?

1. ANormal postictal tiredness that needs no further assessment or imaging at all
2. BA sign that the patient is pretending to be weak
3. CCertainly a stroke, so the seizure can be ignored
4. DPossible postictal (Todd's) paresis, but a stroke must still be excluded

Why do patients with major burns lose so much fluid in the first 24–48 hours?

1. AThe burned skin absorbs fluid from the air
2. BPatients drink far too little in hospital in the first days
3. CLeaky capillaries let plasma move into the tissues
4. DThe kidneys stop making urine completely

After forearm fracture surgery, a patient has severe pain not eased by opioids, made worse by passively moving the fingers. What should the nurse do?

1. AReassure the patient that this pain is expected
2. BLoosen any tight dressing, keep the arm at heart level and escalate
3. CRaise the arm as high as possible and give a further dose of opioid
4. DApply ice and a tighter bandage to reduce the swelling