تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A nurse has called the rapid response team for a deteriorating patient. What should the nurse do while waiting for the team?

1. AStay with the patient, give oxygen as prescribed and have recent vital signs ready
2. BGive a dose of every as-needed medication on the chart
3. CLeave the patient for a few minutes to find the relatives and explain what is happening
4. DGo to the station to finish documentation for other patients

After a vaginal birth, the uterus is firm and central, but bright red blood keeps trickling steadily. What should the nurse suspect?

1. ANormal lochia for the first hour
2. BUterine atony that needs more massage
3. CA full bladder pushing the uterus aside
4. DA tear in the birth canal or cervix

How is a urine specimen for culture obtained from an indwelling catheter?

1. ABy disconnecting the catheter from the drainage tubing
2. BFrom the sampling port, after cleaning it, using aseptic technique
3. CFrom the urine already collected in the drainage bag at the bedside
4. DBy removing the catheter and sending its tip for culture

يحتفظ قسم بقوارير كلوريد البوتاسيوم المركّز في خزانة مخزون القسم. لماذا تنصح إرشادات سلامة كثيرة بعدم ذلك؟

1. Aلأن المركّز غير المخفف إذا أُعطي بالخطأ قد يوقف القلب
2. Bلأن قوارير كلوريد البوتاسيوم تنتهي صلاحيتها خلال يوم من فتحها
3. Cلأن كلوريد البوتاسيوم يجب أن يُعطى دائمًا عن طريق الفم
4. Dلأن كلوريد البوتاسيوم باهظ الثمن بحيث لا يُحفظ كمخزون عام للقسم

A patient with type 2 diabetes has a target HbA1c below 7% (53 mmol/mol). Today's result is 7,8% (62 mmol/mol). What is the best interpretation?

1. AAverage glucose over the past months has been above the target
2. BThe result shows today's fasting glucose is above the target
3. CThe patient has had frequent episodes of severe hypoglycemia
4. DGlucose control has been excellent for the past several months

A patient has a positive hepatitis C antibody (anti-HCV) test. What is the most appropriate next step?

1. ARepeat the antibody test, as a positive test is always false
2. BTell the patient they definitely have chronic hepatitis C
3. CGive hepatitis C vaccine to prevent further infection
4. DTest for HCV RNA to find out whether infection is current

A patient is receiving IV fluids for several days. Which monitoring is essential?

1. APeak flow readings
2. BFluid balance, regular weights and urea, creatinine and electrolytes
3. CWeekly temperature and a single blood glucose reading
4. DMonthly HbA1c

A patient has a single hot, swollen, very painful knee and a fever. Why is urgent joint aspiration important?

1. ATo measure the patient's cholesterol
2. BTo prevent osteoporosis
3. CTo check for rheumatoid arthritis antibodies in the joint fluid
4. DTo rule out septic arthritis, which can rapidly destroy the joint

Which patient is most typical of a primary spontaneous pneumothorax?

1. AAn older woman with long-standing heart failure
2. BA child with a viral sore throat
3. CA tall, thin young man who smokes
4. DA middle-aged woman with high blood pressure

ضغط دم مريض معروف بارتفاع الضغط 186/112 mmHg دون أعراض ودون علامات تلف الأعضاء. أيّ استجابة هي الأنسب؟

1. Aإعطاء جرعة وريدية سريعة من خافض ضغط لبلوغ 120/80 mmHg خلال 15 دقيقة
2. Bإعادة القياس والإبلاغ وتوقع علاج فموي على مدى ساعات إلى أيام
3. Cاستدعاء فريق توقف القلب والتحضير للتنبيب
4. Dعدم اتخاذ أي إجراء، لأن المريض يشعر بحال جيدة ولا أعراض لديه

Which group of problems is typical of primary hyperparathyroidism?

1. AHeat intolerance, tremor, weight loss and diarrhoea
2. BHair loss, weight gain and feeling cold
3. CKidney stones, bone pain, abdominal pain and low mood
4. DMuscle cramps, tingling lips and seizures

A patient with long-standing diabetes suddenly has many new floaters and painless loss of vision in one eye. What is most likely, and what is needed?

1. ADry eyes, needing lubricating drops
2. BA migraine aura, needing pain relief
3. CNormal ageing of the lens, needing new glasses
4. DA bleed into the eye from retinopathy, needing urgent review

How does sucralfate help a peptic ulcer heal?

1. AIt forms a protective coating over the ulcer base
2. BIt blocks histamine receptors on parietal cells
3. CIt speeds up emptying of the stomach
4. DIt kills H. pylori in the stomach lining

A patient with facial burns from a house fire was talking normally on arrival. Two hours later, the voice is hoarse and there is stridor. What should the nurse do?

1. ACall for urgent anaesthetic help, as the airway is swelling
2. BGive a warm drink to soothe the throat
3. CEncourage the patient to rest the voice and reassess tomorrow
4. DLay the patient flat to help them sleep