تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

تطلب ممرضة من مساعد تمريض أن "يقيّم ألم المريض ويقرر ما إذا كان المريض يحتاج إلى مزيد من الدواء". أي حق من حقوق التفويض يُنتهك؟

1. Aالظرف الصحيح
2. Bالشخص الصحيح
3. Cالإشراف والتقويم الصحيحان
4. Dالمهمة الصحيحة

During JumpSTART triage, a child is not breathing after the airway is opened but has a palpable pulse. What is the next step?

1. ATag the child black at once and move on to the next victim
2. BTag the child green and return to them after the others
3. CGive five rescue breaths; if breathing starts, tag the child red
4. DStart full CPR on the child and stay with them until more help arrives

A nurse pours sterile saline into a bowl on a sterile field. Which technique is correct?

1. APour from below the level of the field to reduce splashing
2. BReach across the field to fill the bowl at the far side
3. CHold the bottle with the label in the palm and pour without touching the bowl
4. DRest the lip of the bottle on the edge of the bowl so that the saline does not splash

A nurse discovers that an insulin infusion was programmed using the wrong drug concentration in the pump library. What should the nurse do first?

1. AReprogram the pump and finish the shift before reporting
2. BLeave it running and check the glucose at the next routine time
3. CStop the infusion and check the patient’s blood glucose
4. DDouble the rate to correct for the error

A patient is starting dabigatran, a direct oral anticoagulant. Which laboratory test is most important to review before the first dose?

1. AINR, to set the dose of the anticoagulant
2. BLipase, to rule out an inflamed pancreas first
3. CKidney function (creatinine clearance)
4. DTSH, to rule out an overactive thyroid gland

A patient has fever, confusion, a platelet count of 15 × 10³/µL, anemia with fragmented red cells (schistocytes) and a raised creatinine. Clotting times are normal. Which condition should be suspected?

1. AImmune thrombocytopenia (ITP)
2. BThrombotic thrombocytopenic purpura (TTP)
3. CVitamin K deficiency with bleeding
4. DDisseminated intravascular coagulation

A patient has a continuous stream of bubbles in the water seal chamber of their chest drain. What does this most likely indicate?

1. AAn air leak, from the lung or from the drainage system
2. BThe lung has fully re-expanded
3. CThe drain is blocked
4. DThe drain is working normally for a fluid collection only

Why is morphine more likely to cause toxicity in a patient with severe kidney impairment?

1. AKidney failure makes the stomach absorb more morphine
2. BThe kidneys normally activate morphine, so more of it becomes active
3. CKidney disease makes the opioid receptors disappear
4. DIts active metabolites build up because the kidneys excrete them

أيّ عبارة عن الحجرة الفاصلة (spacer) للمنشق ذي الجرعة المقيسة صحيحة؟

1. Aصُممت لاستخدامها مع المنشقات ذات المسحوق الجاف
2. Bتلزم تنسيق أقل، ويصل دواء أكثر إلى الرئتين
3. Cتجعل كل بخة من الدواء أقوى من المعتاد
4. Dتعني أنه يمكن إيقاف منشق الستيرويد الوقائي تمامًا

Why is the cuff pressure of an endotracheal or tracheostomy tube checked regularly?

1. AThe cuff must be kept fully deflated in every ventilated patient
2. BToo high a pressure damages the trachea; too low allows aspiration
3. CThe cuff pressure sets the ventilator's breathing rate
4. DThe cuff pressure directly controls the patient's oxygen saturation

A patient has just started levetiracetam. Which side effect should the nurse teach them to report?

1. ASwelling and overgrowth of the gums around the teeth
2. BA persistent dry cough at night
3. COrange discoloration of the urine
4. DChanges in mood, such as irritability, low mood or anger

A patient with Guillain–Barré syndrome has a blood pressure that swings between 80/50 and 190/100 mmHg and a heart rate that changes suddenly. What does this suggest?

1. AA faulty blood pressure cuff that should be replaced and the readings ignored
2. BAutonomic dysfunction, which needs continuous cardiac monitoring
3. CA drug reaction that means all medicines must stop
4. DAnxiety that will settle with reassurance alone

لماذا قد لا تعمل الأقراص ممتدة المفعول أو المغلفة معويًا جيدًا لدى مريض الفغر اللفائفي؟

1. Aلأن الفغر يمتص الدواء إلى الدم بسرعة كبيرة جدًا
2. Bلأن أنزيمات الفغر اللفائفي تتلف كل أنواع الأدوية الفموية
3. Cلأن العبور السريع يعني أنها قد تمر قبل أن تطلق الدواء
4. Dلأن مرضى الفغر اللفائفي لا يستطيعون تناول أي أدوية فموية

While a central line is disconnected, a patient suddenly becomes breathless with chest pain and hypotension. Air embolism is suspected. What should the nurse do first?

1. ARemove the central line straight away and leave the site open to the air
2. BGive the patient a drink and observe for an hour
3. CClamp the line, lie the patient left side down, head low; give oxygen
4. DSit the patient fully upright and flush the line