تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

During a blood transfusion, a patient develops chills, back pain and a fever. What is the nurse’s first action?

1. AGive an antipyretic and continue the transfusion
2. BSlow the transfusion and recheck in an hour
3. CFinish the unit quickly through a pressure bag so that the reaction does not last long
4. DStop the transfusion and keep the IV open with normal saline via new tubing

A patient with septic shock remains hypotensive, with a mean arterial pressure of 58 mmHg, after adequate IV fluids. What should the nurse anticipate?

1. AA beta-blocker to slow the heart rate
2. BA loop diuretic to remove the extra fluid that has been given
3. CA vasopressor, such as norepinephrine, to raise the pressure
4. DAn oral fluid challenge with a sports drink

Where should the drainage bag of an indwelling urinary catheter be kept?

1. AOn the bed next to the patient’s hip
2. BOn the floor under the bed, where it is out of the way
3. CHung on the IV pole above the patient
4. DBelow the level of the bladder and off the floor

A patient in a vest restraint has slid down in bed, and the vest is pressing against the neck. What should the nurse do first?

1. ATighten the vest so the patient cannot slide down again
2. BRelease the restraint at once and reposition the patient
3. CWrite a note about the event in the chart
4. DCall the provider to ask about a different restraint

أي تغير في تخطيط كهربية القلب يرتبط بنقص كالسيوم الدم؟

1. Aإطالة الفاصل QT
2. Bموجة دلتا بارزة
3. Cموجات T عالية مدببة
4. Dتقصير الفاصل QT

تناول مريض جرعة زائدة كبيرة من الأسيتامينوفين (باراسيتامول) قبل 24 ساعة. ما التغيرات المخبرية الأكثر توقعًا؟

1. Aانخفاض الكريات البيضاء مع اختبارات كبد طبيعية
2. Bارتفاع التروبونين مع ALT طبيعي
3. Cانخفاض ALT وAST وانخفاض INR
4. Dارتفاع شديد في ALT وAST وارتفاع متزايد في INR

Which is a first-line nursing measure to help prevent constipation in hospital?

1. AEncouraging fluids, fibre and mobility
2. BKeeping the patient in bed
3. CGiving an enema to every patient on admission
4. DRestricting fluids to reduce urine output

A patient is taught to self-inject low-molecular-weight heparin. Which statement shows a need for further teaching?

1. A"I will rub the area firmly after the injection."
2. B"I will report any unusual bleeding or bruising."
3. C"I will change the injection site each time."
4. D"I will inject into the fatty tissue of my abdomen."

أيّ مقياس لشدة الالتهاب الرئوي يستخدم التشوش واليوريا ومعدل التنفس وضغط الدم والعمر؟

1. Aدرجة ويلز
2. BNEWS2
3. CCHA₂DS₂-VASc
4. DCURB-65

A patient being treated for infective endocarditis of the mitral valve suddenly develops slurred speech and weakness of the right arm. What is the most likely cause?

1. AA migraine aura triggered by the fever
2. BA side effect of the IV antibiotic on the nerves
3. CAn embolus from a valve vegetation causing a stroke
4. DLow blood glucose from a reduced appetite

What does a positive pronator drift test show?

1. AWeakness of the eye muscles
2. BLoss of hearing on one side
3. CA normal response in older adults
4. DSubtle weakness in one arm

A patient with an insulin pump is admitted with nausea, a glucose of 19 mmol/L (342 mg/dL) and blood ketones of 3,1 mmol/L. What is the priority?

1. ADisconnect the pump and give no insulin until the ketones clear
2. BSuspect failed insulin delivery and give insulin by another route
3. CGive an antiemetic only, because nausea is causing the high glucose
4. DIncrease the pump rate and recheck the ketones in 12 hours

Which nursing intervention best reduces preoperative anxiety?

1. ATelling the patient that there is nothing to worry about
2. BKeeping family members away until after surgery
3. CAvoiding talking about the operation at all
4. DExplaining what will happen and answering questions

A patient on modified-release morphine for cancer pain has needed four breakthrough doses every day for several days. What should the nurse do?

1. AGive all breakthrough doses at the same time
2. BReport it, as the regular background dose may need review
3. CTell the patient to put up with the pain between doses
4. DStop the breakthrough doses to reduce opioid use