تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A patient with severe neutropenia needs a room. Which roommate is the safest choice?

1. AA patient after a knee replacement with no signs of infection
2. BA patient with influenza
3. CA patient with C. difficile diarrhea
4. DA patient with an infected, draining leg wound

مريض يتلقى تغذية وريدية عبر خط مركزي. أي علامة تحتاج إلى إجراء فوري؟

1. Aزيادة وزن 0,2 kg منذ أمس
2. Bتعرق ورجفة وغلوكوز 62 mg/dL (3,4 mmol/L) بعد توقف التسريب بشكل غير متوقع
3. Cضمادة جافة سليمة فوق الخط
4. Dغلوكوز 150 mg/dL (8,3 mmol/L) أثناء تشغيل التسريب

A nurse gives part of a dose of an opioid from a vial and must discard the rest. What is correct?

1. AReturn the rest to the patient’s medication drawer
2. BKeep the rest for the patient’s next dose
3. CDiscard it in front of a second licensed (registered) nurse, who witnesses and documents it
4. DDiscard it alone in the sink and document the amount wasted later in the shift

A hospital will introduce new infusion pumps and wants to find out how the process could fail before any harm occurs. Which method fits best?

1. AAn incident report for each new pump
2. BFailure mode and effects analysis (FMEA)
3. CA morbidity and mortality meeting
4. DRoot cause analysis (RCA) of the new pumps

أي علاج يخفض بوتاسيوم المصل بنقله إلى داخل الخلايا؟

1. Aغلوكونات الكالسيوم الوريدي على مدى 10 دقائق
2. Bالإنسولين العادي الوريدي مع الغلوكوز
3. Cمكملات كلوريد البوتاسيوم الفموية
4. Dتسريب كلوريد الصوديوم الوريدي 0,45%

A patient with acute kidney injury has a potassium of 6,8 mEq/L despite medical treatment, a pH of 7,12 and pulmonary edema not responding to diuretics. Which treatment is most likely needed?

1. AUrgent dialysis
2. BA potassium supplement
3. CMore oral fluid
4. DAn IV magnesium dose

What is one advantage of a direct oral anticoagulant (DOAC) such as apixaban compared with warfarin?

1. AIt never interacts with other drugs
2. BIt does not need routine INR monitoring
3. CIt has no risk of bleeding
4. DIt is safe in all patients with severe kidney failure

A patient has a swollen, warm, tender calf on one side. Which action should the nurse avoid?

1. AReporting the findings to the doctor
2. BChecking whether VTE prophylaxis was given
3. CMeasuring and comparing calf circumference
4. DMassaging the calf

After thrombolysis for a myocardial infarction, which complication is the nurse most concerned to detect?

1. AA skin rash appearing at the sites of the ECG electrodes
2. BConstipation from bed rest
3. CA high blood glucose caused by the thrombolytic drug itself
4. DBleeding, including a sudden change in neurological status

A 70-year-old man has a small abdominal aortic aneurysm found on screening and is placed under surveillance. Which advice is most important?

1. AAvoid all exercise and lifting for the rest of his life to protect the aorta
2. BStop all blood pressure medicines to avoid low pressure
3. CHave the aneurysm repaired immediately, whatever its size or growth rate
4. DStop smoking, control BP and seek help at once for sudden back pain

Which statement about giving IV potassium is correct?

1. AIt is safest given through a small vein in the hand at a fast rate
2. BIt can be given quickly as a push to correct the level fast
3. CIt needs no monitoring at all once the infusion is running
4. DIt is diluted and given through an infusion pump, never as a bolus

A student has fever, a severe headache, a spreading non-blanching rash and a BP of 85/50 mmHg. A lumbar puncture is planned. What is the priority?

1. AArrange a CT scan of the head before any treatment
2. BWait until after the lumbar puncture before giving antibiotics
3. CGive paracetamol (acetaminophen) and recheck observations in an hour
4. DGive IV antibiotics at once and start sepsis treatment

Which is a recognised cause of anaphylaxis during surgery?

1. AChlorhexidine skin preparation
2. BA warmed blanket
3. CSterile normal saline
4. DThe patient's own blood from cell salvage

A nurse teaches a patient after a laparoscopic fundoplication for reflux. Which statement shows a need for further teaching?

1. A"I'll eat soft, moist food at first and chew it well."
2. B"Fizzy drinks will help me bring up wind after meals."
3. C"Some difficulty swallowing can happen in the early weeks."
4. D"I should eat smaller meals for a while after the operation."