تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

After a hip replacement, a patient has sudden severe hip pain, and the operated leg looks shorter and turned. What should the nurse suspect?

1. AA urinary tract infection
2. BNormal pain after surgery
3. CA pressure injury on the heel
4. DDislocation of the new hip

A provider asks a nurse to perform a procedure that is outside the nurse’s scope of practice. What should the nurse do?

1. ADecline, explain why and suggest who can safely do it
2. BDo it just this once and promise the provider not to do it again
3. CAsk a nursing assistant to do it instead
4. DDo it, because the provider gave the instruction

A nurse cleans an IV pump with a disinfectant wipe. What must happen for the disinfectant to work?

1. AThe surface is wiped once lightly without pressure
2. BThe surface stays wet for the contact time on the product label
3. CThe surface is dried with a clean towel right after wiping
4. DThe wipe is used on many pumps to save product

A patient given naloxone for an opioid overdose wakes up. An hour later, the patient is drowsy again with slow breathing. What is the likely reason?

1. ANaloxone wears off sooner than many opioids, so the opioid effect returns
2. BThe patient is now allergic to naloxone
3. CThe patient is simply tired after the event
4. DNaloxone itself causes slow breathing and drowsiness once it has been given

A patient takes high-dose biotin supplements for hair and nails. Why should the nurse report this before blood tests?

1. ABiotin causes a true rise in blood glucose in all patients
2. BBiotin makes the blood clot in the tube before testing
3. CBiotin lowers the hemoglobin by destroying the red cells
4. DBiotin can distort some immunoassays, such as troponin or TSH

مريض بقصور القلب كان BNP لديه مرتفعًا جدًا عند الإدخال وينخفض الآن بعد العلاج بالمدرات. على ماذا يدل ذلك على الأرجح؟

1. Aوجوب إيقاف المدر فورًا
2. Bشدّ أقل على القلب، بما يتفق مع التحسن
3. Cتفاقم قصور القلب الذي يحتاج إلى مزيد من السوائل
4. Dفشل كلوي جديد ناجم عن المدر

عند إعطاء الإنسولين، أيّ عبارة صحيحة؟

1. Aيجب رجّ الإنسولين بقوة قبل الاستخدام
2. Bتبديل مواقع الحقن لتجنب الضخامة الشحمية
3. Cالحقن دائمًا في المكان نفسه لامتصاص ثابت
4. Dيُعطى الإنسولين سريع المفعول عند النوم فقط

مريض بعد جراحة كبرى ضغطه ينخفض ومعدل قلبه يرتفع وبطنه متورم ومتوتر، رغم أن ضماد الجرح جاف. ماذا يجب أن تشتبه؟

1. Aنزف داخلي
2. Bتورم طبيعي بعد الجراحة لا يثير القلق
3. Cالإمساك
4. Dعدوى المسالك البولية

A patient on nasal cannula oxygen breathes mainly through the mouth. What is the most accurate statement?

1. AThe cannula should be placed in the mouth
2. BIt can still work, because oxygen collects in the nasopharynx
3. CIt has no effect at all in mouth breathers and must be stopped
4. DThe flow must be increased to 15 L/min to make it work at all

A patient on an unfractionated heparin infusion has a nosebleed that will not stop, and the aPTT is far above the target range. What is the most appropriate action?

1. AContinue the infusion at the same rate and pack the nose firmly
2. BIncrease the infusion, as the aPTT will settle
3. CGive vitamin K and continue the infusion at a slightly lower rate
4. DStop the infusion, inform the prescriber and anticipate protamine

لدى مريض عمى نصفي متماثل الجانب بعد سكتة. كيف ينبغي أن تساعده الممرضة في البداية؟

1. Aوضع جرس النداء والمشروبات في الجانب غير المبصر لتدريبه
2. Bإبقاء الغرفة مظلمة لتقليل التنبيه البصري
3. Cتغطية العين في الجانب المصاب بلصاقة
4. Dالاقتراب من الجانب المبصر وتعليمه إدارة الرأس للمسح

On day 6 after a subarachnoid haemorrhage, a patient becomes newly confused and develops weakness in one arm. The aneurysm was secured on day 1. What is the most likely cause?

1. ANormal tiredness after major surgery
2. BRe-bleeding from the secured aneurysm
3. CHypoglycaemia from reduced eating
4. DDelayed cerebral ischaemia from vasospasm

Which check is routinely made for a patient with a burn wound?

1. ATetanus immunisation status
2. BMeasles vaccination status
3. CBlood group of the next of kin
4. DVisual acuity in both eyes

During a nerve block, a patient reports a metallic taste and ringing in the ears, then has a seizure. Besides calling for help and supporting the airway, which specific treatment is given?

1. AIV lipid emulsion
2. BIV glucose 50%
3. CIV naloxone
4. DIV dantrolene