تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

An older patient with dementia is restless at night and keeps trying to get out of bed. Which measure should the nurse try first?

1. AApply wrist restraints for the rest of the night
2. BGive a sedative from the as-needed list without first assessing the patient
3. CRaise all four bed rails so the patient cannot climb out
4. DCheck for pain, thirst or a full bladder, and offer toileting

A patient has a potassium of 7,0 mEq/L with peaked T waves. Several drugs are prescribed. Which one is usually given first to protect the heart?

1. AIV furosemide
2. BOral sodium bicarbonate
3. COral potassium binder
4. DIV calcium gluconate

Where is a gait belt placed when helping a patient to walk?

1. AAround the hips, directly on bare skin
2. BAround the patient’s waist, over clothing
3. CAround both thighs, just above the knees
4. DAround the chest, under the arms

ينص أمر مكتوب بخط اليد على «10U إنسولين عادي تحت الجلد الآن». ما أفضل إجراء للممرضة؟

1. Aإعطاء 10 وحدات دون سؤال، كما هو مكتوب
2. Bتوضيح الأمر، لأن «U» قد تُقرأ خطأً
3. Cإعطاء 100 وحدة، كما يبدو أن الأمر ينص
4. Dأن تطلب من مساعد تمريض تفسير الخط

بعد جراحة النخامية، يخرج مريض نحو 400 mL من بول شاحب في الساعة بكثافة نوعية 1,002، وقد ارتفع الصوديوم إلى 149 mEq/L. أي حالة هي الأرجح؟

1. ASIADH
2. Bفرط سكر الدم مع الحماض الكيتوني
3. Cالسكري الكاذب
4. Dإصابة كلوية حادة مع قلة البول

The nurse teaches a patient starting lithium. Which statement shows a need for further teaching?

1. A"I will check with the pharmacist before taking ibuprofen"
2. B"I will tell my doctor if I have vomiting or diarrhea"
3. C"I will drink plenty of fluids, especially in hot weather"
4. D"I will cut out salt from my diet completely to stay healthy"

A patient with dysphagia after a stroke has been cleared for a modified diet. How should they be positioned for meals?

1. ALying on their side with the knees bent
2. BSemi-reclined at about 20 degrees, with the head supported on pillows
3. CLying flat on their back with the head turned to one side
4. DSitting fully upright, and staying upright for a time after eating

ممرضة غير متأكدة مما إذا كانت الجرعة الموصوفة من دواء عالي الخطورة صحيحة. ما الإجراء الأكثر أمانًا؟

1. Aإعطاء الجرعة لأن الطبيب وقّع الوصفة
2. Bحجب الجرعة والتحقق أولًا مع الواصف أو الصيدلي
3. Cإعطاء نصف الجرعة حلًا وسطًا حتى يتوفر الطبيب
4. Dسؤال المريض عما إذا كانت الجرعة تبدو كالمعتاد ثم إعطاؤها

Why does a large, rapidly forming pericardial effusion lower the blood pressure?

1. AIt compresses the heart and stops the ventricles filling
2. BIt dilates the arteries throughout the body
3. CIt causes the aortic valve to leak backwards into the ventricle
4. DIt makes the heart muscle contract too strongly and too fast

After a faulty gas heater was found at home, a patient has headache, nausea and confusion. SpO₂ is 99% on air. What is the priority treatment?

1. AParacetamol (acetaminophen) and observation only
2. BReassurance, because the oxygen saturation is normal
3. COxygen at 1 L/min via nasal cannula
4. DHigh-concentration oxygen via a non-rebreather mask

What is the dexamethasone suppression test used for?

1. ATo measure kidney function
2. BTo diagnose diabetes insipidus
3. CTo check thyroid function
4. DTo help diagnose Cushing's syndrome

A patient arrives five hours after the onset of a stroke. A CT angiogram shows a blockage of a large artery in the brain. What is the most appropriate next step?

1. ANo treatment, because the time for any reperfusion has passed
2. BStart IV alteplase immediately without further imaging
3. CGive aspirin and plan a review on the ward tomorrow
4. DUrgent referral for assessment for mechanical thrombectomy

Which instruction is important during bowel preparation for colonoscopy?

1. ATake the preparation only if the bowels have not opened
2. BDrink plenty of clear fluids while taking the preparation
3. CEat a high-fibre meal the evening before the test
4. DAvoid all fluids for 24 hours before the test

A patient with haematemesis becomes drowsy and starts to vomit blood again. What is the immediate priority?

1. AComplete the admission paperwork and medication history
2. BTurn the patient onto their side to protect the airway
3. CGive a large glass of iced water to slow the bleeding
4. DSend a stool sample for faecal occult blood testing