تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

Which action helps prevent a catheter-associated urinary tract infection?

1. ALeaving the catheter in place longer than needed
2. BKeeping the drainage bag below the level of the bladder
3. CDisconnecting the bag every shift to empty it
4. DRaising the drainage bag above the bladder when walking

A patient is bleeding internally after a fall. Which finding is usually an early sign of hypovolemic shock?

1. AA slow heart rate with warm, dry, flushed skin and a normal blood pressure throughout
2. BLoss of consciousness with gasping breaths
3. CA very low blood pressure with fixed, dilated pupils
4. DRestlessness and a rising heart rate while the blood pressure is still normal

How are neuromuscular blocking drugs, such as vecuronium, safely stored?

1. ASeparate from other drugs, with a warning that they cause paralysis
2. BMixed in the same bin as other high-use drugs
3. CIn the general stock cupboard with the other IV drugs and no special labels
4. DNext to common IV antibiotics so they are easy to find

A small-bore feeding tube has just been inserted blindly at the bedside. Which method is the most reliable way to confirm its position before the first feeding?

1. ABy listening over the stomach while injecting air
2. BBy checking that the patient can still talk
3. CBy putting the end in water to look for bubbles
4. DBy an x-ray reviewed by a competent clinician

The heparin infusion rate was changed according to protocol. When is the aPTT usually rechecked?

1. AAbout 3 days after the change
2. BAbout 6 hours after the change
3. COnly after the infusion is stopped
4. DAbout 30 minutes after the change

Four results arrive at the same time. Which patient should the nurse see first?

1. AINR 2,6 in a patient on warfarin for atrial fibrillation
2. BHemoglobin 10,4 g/dL (104 g/L) in a patient with stable chronic kidney disease
3. CGlucose 48 mg/dL (2,7 mmol/L) in a patient who had insulin an hour ago
4. DWhite cell count 12,0 × 10³/µL on the first day after surgery

During a vesicant chemotherapy infusion, the patient reports burning and swelling at the cannula site. What should the nurse do first?

1. AApply a warm pack and continue the infusion
2. BIncrease the rate so that the infusion finishes as quickly as possible
3. CFlush the cannula hard with saline
4. DStop the infusion straight away and follow the extravasation protocol

مريض يعاني الغثيان والقيء منذ ثلاثة أيام ويتناول الفوروسيميد. ما اضطراب الكهارل الأرجح؟

1. Aفرط صوديوم الدم فقط
2. Bفرط بوتاسيوم الدم
3. Cنقص بوتاسيوم الدم
4. Dفرط كالسيوم الدم

Why should a long-acting beta-2 agonist (LABA) never be used alone in asthma?

1. AIt always causes immediate severe bronchospasm when used on its own
2. BIt works only when it is taken together with a course of antibiotics
3. CWithout an inhaled steroid, it is linked with severe and fatal attacks
4. DIt cannot be inhaled without a nebuliser

مريض مصاب بالربو ذروة تدفقه 40% من أفضل قيمة لديه، ومعدل تنفسه 28/min، ولا يستطيع إكمال الجمل. SpO₂ 94%. كيف تُصنَّف هذه النوبة؟

1. Aربو مهدد للحياة
2. Bربو شبه مميت
3. Cتفاقم ربو متوسط
4. Dربو حاد شديد

Which picture fits Brown-Séquard syndrome?

1. AWeakness of both arms with normal strength in the legs
2. BParalysis of both legs, with normal sensation everywhere in the body
3. CLoss of all feeling but normal movement on both sides
4. DWeakness on the same side and loss of pain on the opposite side

After a stroke, a patient suddenly cries or laughs at odd moments. They say they do not feel sad. Which response is most appropriate?

1. AExplain that this is emotional lability after stroke and help the family understand
2. BAsk the doctor for a sedative to stop the outbursts
3. CIgnore it, because it shows that the patient is seeking attention from the staff
4. DTell the patient that crying will slow their recovery

What is the main treatment for a venous leg ulcer with an adequate arterial supply?

1. ASurgery to amputate the limb
2. BStrong oral antibiotics for all ulcers
3. CCompression therapy
4. DKeeping the leg hanging down all day

During bowel preparation, an older patient becomes dizzy and confused. Blood tests show sodium 127 mmol/L. What should the nurse do?

1. AStop the preparation and escalate to the medical team
2. BEncourage plain water only, as much as possible
3. CGive the rest of the preparation more quickly
4. DRecord it and continue as planned, as this is expected