تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

On the first day after abdominal surgery, a patient has a temperature of 37,9 °C and reduced breath sounds at the lung bases. Which nursing action is most helpful?

1. AGive a cough suppressant so that the incision is not strained
2. BRestrict oral fluids so that the lungs do not fill up with extra fluid
3. CEncourage deep breathing, coughing and use of the incentive spirometer
4. DKeep the patient lying flat in bed to rest the incision fully

في قسم الطوارئ، أي مريض ينبغي أن يذهب مباشرة إلى غرفة العلاج؟

1. Aشخص عمره 45 سنة يطلب وصفة متكررة
2. Bشخص عمره 60 سنة بضغط في الصدر وتعرق وغثيان منذ 20 دقيقة
3. Cشخص عمره 30 سنة بالتهاب حلق منذ يومين وحرارة 38,0 °C
4. Dشخص عمره 25 سنة بالتواء في المعصم وعلامات حيوية طبيعية

A colleague has drawn up a medication and asks the nurse to give it to her patient. What should the nurse do?

1. AGive it, because the colleague is experienced
2. BDecline, and give only medications that the nurse prepared or checked personally
3. CGive it, and document that the colleague prepared it
4. DGive it, as long as the syringe has a label with the drug name on it

During flu season, a nurse wakes up with fever, cough and muscle aches. What is the best action?

1. ATake an antipyretic so the fever does not show at work
2. BGo to work but wear a surgical mask for the whole shift
3. CGo to work but avoid caring for patients who have weak immune systems
4. DStay home and inform the employer according to the illness policy

مريض موعد الديجوكسين مستحق له بوتاسيومه 3,1 mEq/L. لماذا هذه النتيجة مهمة؟

1. Aيجعل انخفاض البوتاسيوم الديجوكسين غير فعّال، لذلك ينبغي مضاعفة الجرعة
2. Bيحمي انخفاض البوتاسيوم القلب من الآثار الجانبية للديجوكسين
3. Cيزيد انخفاض البوتاسيوم خطر سمية الديجوكسين
4. Dلا يتداخل البوتاسيوم والديجوكسين

A patient with acute kidney injury has a potassium of 6,8 mEq/L despite medical treatment, a pH of 7,12 and pulmonary edema not responding to diuretics. Which treatment is most likely needed?

1. AUrgent dialysis
2. BA potassium supplement
3. CAn IV magnesium dose
4. DMore oral fluid

Which equipment must always be kept at the bedside of a patient with a tracheostomy?

1. ASpare tracheostomy tubes, including one a size smaller, and working suction
2. BA peak flow meter and a nebuliser
3. CA blood glucose meter and a spare urinary catheter of the same size
4. DA blood pressure cuff and a spare nasal cannula and oxygen mask only

Which drug group is first-line for a prolonged convulsive seizure?

1. AAntihistamines, such as chlorphenamine
2. BBenzodiazepines, such as buccal midazolam or IV lorazepam
3. COpioids, such as morphine or diamorphine, given intravenously
4. DBeta-blockers, such as bisoprolol or atenolol

لماذا لا ينبغي عادةً تثبيت أنبوب مفجّر الصدر بملقط؟

1. Aلأن الإطباق يُضعف الأنبوب ويشققه بشكل دائم
2. Bلأن الإطباق يجعل السائل يتصرف من الصدر بسرعة كبيرة جدًا
3. Cلأن الهواء المحتبس قد يتراكم ويسبب استرواح صدر توتريًا
4. Dلأن الإطباق يسبب تبخر الماء في الصمام

A patient with obstructive sleep apnoea who uses CPAP at home is having surgery. Which plan is safest after the operation?

1. ANurse the patient lying flat on their back to keep the airway open
2. BLeave the CPAP machine at home, as it is not needed while in hospital
3. CUse their CPAP machine and monitor closely, using opioids with caution
4. DGive extra opioids so the patient sleeps through the night

A nurse is teaching a patient going home after a mild concussion. Which statement shows a need for further teaching?

1. A"I will come back if I start vomiting again and again."
2. B"I will return if my headache gets steadily worse."
3. C"A few drinks tonight will help me relax and sleep."
4. D"Someone will stay with me for the first night."

A 74-year-old falls forward and hits their chin. Their arms are much weaker than their legs, and they have burning pain in the hands. Which injury is most likely?

1. ABrown-Séquard syndrome
2. BCauda equina syndrome
3. CCentral cord syndrome
4. DA complete lumbar cord injury

During the first infusion of a monoclonal antibody such as rituximab, which problem is most important to watch for?

1. AAn infusion reaction, such as fever, rigors or breathlessness
2. BA rise in platelet count above normal
3. CSudden hair loss during the infusion
4. DSevere constipation within the first hour of starting the infusion

A patient has a category (stage) 2 pressure ulcer on the sacrum. Which plan is most appropriate?

1. ALeave it uncovered and dry it with a hair dryer
2. BOffload the area, manage moisture, support nutrition and dress it
3. CSit the patient upright in a chair for most of the day
4. DMassage around the wound every hour to stimulate blood flow to the skin