تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A patient wants to leave the hospital against medical advice. What should the nurse do?

1. AInform the provider, explain the risks and document the discussion
2. BLock the door so the patient cannot leave the unit
3. CLet the patient leave without telling anyone
4. DHide the patient’s clothes and belongings until the provider arrives

A 2-month-old infant has a spiral fracture of the femur. The parents say the baby rolled off the sofa. What should the nurse recognize?

1. AInfants of this age often roll off furniture and break bones in this way
2. BNo further action is needed once the fracture is treated
3. CA spiral fracture in an infant is always caused by birth trauma
4. DThe injury does not fit the infant’s development, so possible abuse must be reported

When should blood specimen tubes be labeled?

1. ABy the laboratory staff after the tubes arrive
2. BAt the bedside, in front of the patient, right after collection
3. CAt the nurses’ station before going to the patient, to save time
4. DBack at the station after all the samples are collected

A patient is admitted with suspected pneumonic plague after a possible bioterrorism release. Which precautions are used?

1. ADroplet precautions
2. BAirborne precautions
3. CContact precautions only
4. DStandard precautions only

In the third trimester of pregnancy, a woman's alkaline phosphatase (ALP) is about twice the usual adult range, and the other liver tests are normal. What is the best interpretation?

1. AA normal rise from placental ALP
2. BA sign of new bone cancer
3. CA sign of acute viral hepatitis
4. DA sign of blocked bile ducts

A patient's total calcium is 7,6 mg/dL and the albumin is 2,0 g/dL. Using the common correction (add 0,8 mg/dL for each 1 g/dL that albumin is below 4,0), what is the corrected calcium?

1. A9,2 mg/dL, within the normal range
2. B7,6 mg/dL, below the normal range
3. C6,0 mg/dL, well below the normal range
4. D11,6 mg/dL, above the normal range

تبدو فغرة قولونية جديدة أرجوانية داكنة إلى سوداء في اليوم الثاني بعد الجراحة. على ماذا يدل ذلك؟

1. Aفغرة سليمة طبيعية
2. Bكدمات طبيعية بعد الجراحة في الفغرة لا تحتاج إلى إجراء
3. Cاحتمال نقص تروية الفغرة، مما يستلزم مراجعة عاجلة
4. Dالإمساك

A patient has a high fever with rigors, jaundice and right upper quadrant pain. Which condition is most likely?

1. AAscending cholangitis
2. BSimple biliary colic
3. CAcute appendicitis
4. DGastro-oesophageal reflux disease

A patient has chest pain at rest in the early morning with brief ST elevation that resolves. Coronary arteries are later found to be clear. Which condition is most likely?

1. AVasospastic (Prinzmetal) angina
2. BAortic stenosis
3. CAcute pericarditis
4. DStable exertional angina from a fixed plaque

After a fall onto the chest, part of a patient's chest wall moves inward when they breathe in and outward when they breathe out. What does this indicate?

1. AA large pleural effusion pressing on the chest wall
2. BNormal chest movement caused by pain on breathing
3. CA flail chest from ribs broken in more than one place
4. DA single simple rib fracture with no lung injury

How does the nurse test the facial nerve (VII)?

1. AShine a light in each eye and check the pupil response
2. BAsk the patient to stick out the tongue and move it from side to side
3. CAsk them to raise the eyebrows, shut the eyes tightly and smile
4. DTouch the forehead, cheek and chin with cotton wool

يسأل مريض غسيل دموي لماذا يجب تحديد السوائل بين الجلسات. أيّ تفسير صحيح؟

1. Aتتراكم السوائل الزائدة فتزيد الضغط وتسبب ضيق النفس والتشنجات أثناء الغسيل
2. Bالسوائل الزائدة تُضعف جدار الناسور فيزداد احتمال انفجاره
3. Cشرب الماء يجعل الغسيل يزيل بوتاسيوم أكثر من اللازم من الدم
4. Dتقييد السوائل يهدف أساسًا إلى تقصير الوقت المقضي على الجهاز

Which liver function test pattern suggests bile duct obstruction?

1. AA low albumin with all other results normal
2. BVery high ALT with a normal bilirubin only
3. CHigh bilirubin with a markedly raised ALP and GGT
4. DNormal bilirubin with a low ALP and low GGT

A sacral wound has heavy exudate, and the surrounding skin is white, soft and wrinkled. What should the nurse do?

1. ALeave the same dressing in place for a week so the wound is not disturbed
2. BUse a dressing that adds even more moisture
3. CProtect the skin edges and use a more absorbent dressing
4. DApply a tight plastic film directly over the wound