تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A patient is raising his voice, pacing and clenching his fists. What should the nurse do first?

1. AStand very close to him and tell him firmly and loudly to sit down and be quiet
2. BSpeak calmly, keep a safe distance and invite him to talk about what is wrong
3. CApply physical restraints at once
4. DTurn away and ignore the behavior

خروج أي مريض مخطط له ينبغي أن تستوضحه الممرضة؟

1. Aمريض بعد إصلاح فتق يتبول ويأكل
2. Bمريض بجبيرة مستقرة يمشي بأمان بالعكازين
3. Cمريض ذات رئة بلا حمّى منذ 48 ساعة على مضادات حيوية فموية
4. Dمريض بعد يومين من الجراحة معدل نبضه الجديد 112/min وحرارته 38,4 °C

How should a nurse handle soiled bed linen?

1. ACarry it bundled against the body to the soiled utility room down the hall
2. BShake it out first to check for lost items
3. CHold it away from the uniform and place it straight into a linen bag
4. DPut it on the floor until the bed is made

A patient has signed a surgical consent form but tells the nurse, “I don’t really understand what they are going to do.” What should the nurse do?

1. AGive the preoperative sedative so the patient relaxes
2. BInform the surgeon so the procedure can be explained again before any sedation
3. CExplain the risks and benefits in place of the surgeon
4. DReassure the patient that the surgeon knows best and continue with the preparation

A patient with sickle cell disease takes hydroxyurea. Which laboratory test is monitored regularly for an adverse effect?

1. ASerum amylase level
2. BSerum lithium level
3. CComplete blood count
4. DUrine ketone level

After lying on the floor for many hours, a patient has a CK of 40,000 U/L, a potassium of 6,1 mEq/L and dark urine. Which prescribed treatment is the priority?

1. AHigh-dose NSAIDs for the muscle pain
2. BAn oral potassium supplement with each meal
3. CLarge-volume IV fluids with cardiac monitoring
4. DFluid restriction to protect the heart from overload

What is the most common cause of hypernatraemia in frail older inpatients?

1. ATaking too many vitamins
2. BNot drinking enough water
3. CEating too much salt in one meal
4. DToo much exercise

A patient going home with a leg cast is taught about cast care. Which statement shows a need for further teaching?

1. A"I will keep the cast dry."
2. B"I can push a knitting needle down the cast to scratch an itch."
3. C"I will come back if my toes go numb or turn blue."
4. D"I will keep my leg raised on pillows for the first few days."

How is a patient usually positioned for a thoracentesis?

1. ASitting upright and leaning forward over a table
2. BLying on the affected side with the head down
3. CFlat on the back with the legs raised
4. DProne with the arms by the sides

On a ventilated patient, the end-tidal CO₂ waveform suddenly drops to zero. What should the nurse suspect first?

1. ATube displacement, disconnection or obstruction
2. BA sudden improvement in the patient's lung function
3. CNormal variation that needs no action
4. DA rise in the patient's body temperature over the last hour

مريض سكتة يفهم ما يُقال لكنه يعاني إيجاد الكلمات ويتكلم بعبارات قصيرة متعبة. ما نوع الحبسة؟

1. Aحبسة شاملة بلا فهم
2. Bحبسة تعبيرية (بروكا)
3. Cحبسة استقبالية (فيرنيكه)
4. Dعسر التلفظ بسبب ضعف عضلات الوجه

During a TURP, a patient becomes confused and nauseated, with a slow pulse and a raised BP. The sodium is 121 mmol/L. What is most likely?

1. ATURP syndrome from absorbed irrigation fluid
2. BA normal reaction to the spinal anaesthetic
3. CAn allergic reaction to the catheter
4. DHypoglycaemia from fasting for many hours before surgery

Which factor can precipitate hepatic encephalopathy in a patient with cirrhosis?

1. AA low-salt diet
2. BA high fluid intake
3. CRegular gentle walking
4. DConstipation

مريض لديه فغر لفائفي بلا خرج منذ 6 ساعات، مع ألم تقلصي وانتفاخ وغثيان وتورم في الفغر. ماذا ينبغي أن تشتبه الممرضة؟

1. Aانسداد في الفغر، غالبًا من الطعام، يحتاج إلى مراجعة
2. Bفترة هدوء طبيعية لفغر لفائفي جديد
3. Cجفاف من خرج لفائفي غزير جدًا
4. Dطفح جلدي بسيط حول الفغر