تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A patient is receiving continuous tube feeds. Which action best reduces the risk of aspiration?

1. ATurn the feed off only while the patient is asleep at night
2. BLay the patient flat for an hour after each bag is hung
3. CKeep the head of the bed raised to at least 30 degrees
4. DIncrease the feed rate so the stomach empties sooner

A competent adult patient refuses a blood transfusion for religious reasons. What should the nurse do?

1. AAsk the family to persuade the patient until they agree
2. BGive the transfusion while the patient is asleep, because saving their life comes first
3. CRespect the refusal, check the patient understands the risks and inform the provider
4. DTell the patient that refusing treatment is not allowed in hospital

A family member will visit a patient on contact precautions. What should the nurse do?

1. AAsk them to wear an N95 respirator only, with no gown or gloves
2. BTell them precautions only apply to staff
3. CShow them how to use the gown and gloves and how to clean their hands
4. DTell them visits are not allowed at all

Before the wound is closed, the sponge count does not match the starting count. What should happen?

1. AAssume that the first count was wrong and continue
2. BClose the wound to avoid a long anesthetic and recount the sponges after surgery
3. CTell the surgeon and team, search for the item, and image the patient per policy if it is not found
4. DChange the count on the record so that it matches, then close the wound as planned

A tired patient with heavy menstrual periods has a normal hemoglobin and MCV but a ferritin of 8 ng/mL. What does this show?

1. AVitamin B₁₂ deficiency anemia
2. BA completely normal iron status
3. CIron deficiency without anemia yet
4. DIron overload from too much iron

A healthy woman at 10 weeks of pregnancy has a slightly low TSH with a normal free T₄ and no symptoms. What is the most likely explanation?

1. AShe has pituitary failure from the pregnancy
2. BShe has developed Graves disease in pregnancy
3. CThe result shows severe primary hypothyroidism
4. DhCG stimulates the thyroid in early pregnancy

Why are patients with atrial fibrillation often given anticoagulants?

1. ATo reduce the risk of stroke from clots in the atria
2. BTo lower the blood pressure
3. CTo slow the heart rate directly and prevent palpitations
4. DTo convert the rhythm back to normal

After a viral illness, a patient has sharp chest pain that is worse lying flat and eased by sitting forward. What is the most likely cause?

1. APericarditis
2. BStable angina
3. CPulmonary oedema
4. DAortic dissection

توقف السائل في مفجّر الصدر عن التأرجح. ماذا قد يعني ذلك؟

1. Aبدأت وحدة التصريف تصرّف البطن
2. Bمستوى الماء في الحجرة أصبح مرتفعًا بحيث لا يتحرك
3. Cعادت الرئة إلى التمدد، أو الأنبوب ملتوٍ أو مسدود
4. Dحدث استرواح صدر جديد في الجانب الآخر

A nurse receives handover on four patients. Which patient should be seen first?

1. AA patient with asthma who wants a reliever inhaler before a walk
2. BA patient with pneumonia on IV antibiotics who now has a temperature of 38,2 °C
3. CA patient with COPD on 1 L/min whose SpO₂ has been 89% and stable throughout the night
4. DA patient on day 1 after surgery who is newly restless, RR 30/min, SpO₂ 88% on 4 L/min

Why is propranolol given to a patient with hyperthyroidism?

1. ATo stop the thyroid gland from making any more hormones
2. BTo destroy overactive thyroid tissue over a few weeks
3. CTo ease tremor and palpitations while other treatment starts
4. DTo replace the hormone lost from the thyroid gland

The nurse has four renal patients. Which one needs to be seen first?

1. AA patient with a creatinine slightly above their usual level
2. BA patient with mild itching from uraemia who wants a cream
3. CA patient with a potassium of 6,8 mmol/L who reports palpitations
4. DA patient with CKD asking about their phosphate binder

في أيّ فترة بعد الجراحة يكون تفكك الجرح (wound dehiscence) الأرجح؟

1. Aأثناء العملية فقط
2. Bبعد أكثر من سنة من الجراحة
3. Cخلال الساعة الأولى
4. Dنحو 5–10 أيام بعد الجراحة

مريضة مصابة بسرطان الثدي تصاب بتشوش وعطش وإمساك مع بوال. أيّ طارئة ورمية ينبغي النظر فيها؟

1. Aمتلازمة انحلال الورم
2. Bفرط كالسيوم الدم الناجم عن الورم الخبيث
3. Cانسداد الوريد الأجوف العلوي
4. Dنقص سكر الدم