تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A patient with angina is taught to use sublingual nitroglycerin (GTN). Which statement shows a need for further teaching?

1. A“I will take five tablets one after the other before I call for help.”
2. B“If the pain has not eased as my action plan says, I will call emergency services.”
3. C“I will sit or lie down when I take a tablet.”
4. D“I will carry the tablets with me when I go out.”

A patient with SIADH has a serum sodium of 120 mEq/L and is newly confused. Which nursing action has priority?

1. ASeizure precautions and close neurological checks
2. BHelping the patient to walk in the corridor alone
3. CTeaching the patient about a low-sodium diet at home
4. DEncouraging the patient to drink plenty of water

A peripheral IV site is red, warm and tender along the vein. What should the nurse do?

1. ARemove the catheter and insert a new one at another site if still needed
2. BIncrease the infusion rate to finish the bag sooner
3. CApply a warm pack and keep using the same site
4. DFlush the catheter harder to clear the vein and keep using the same site

A visitor becomes very agitated and starts shouting at the nurse in a patient’s room. What should the nurse do first?

1. ATurn away from the visitor and continue with the patient’s care as normal
2. BRaise the voice to show who is in charge
3. CTouch the visitor’s arm to help them calm down
4. DKeep a safe distance and a clear exit, speak calmly and call security if needed

العدد المطلق للعدلات لدى مريض 0,4 × 10³/µL. أي إجراء مناسب؟

1. Aمشاركة الغرفة مع مريض آخر يُعالَج من ذات الرئة
2. Bإدخال زهور طازجة إلى الغرفة لرفع معنويات المريض
3. Cنظافة صارمة لليدين ومراقبة الحرارة ومنع الزوار المصابين بعدوى
4. Dقياس الحرارة شرجيًا لأن القراءات أدق

A healthy woman at 10 weeks of pregnancy has a slightly low TSH with a normal free T₄ and no symptoms. What is the most likely explanation?

1. AShe has pituitary failure from the pregnancy
2. BhCG stimulates the thyroid in early pregnancy
3. CShe has developed Graves disease in pregnancy
4. DThe result shows severe primary hypothyroidism

During a red cell transfusion, when are serious acute reactions most likely to start?

1. AIn the first 15 minutes
2. BAbout 24 hours later
3. CAfter the third unit only
4. DOnly after the unit has finished

A nurse notices that a wrong dose of a drug was prepared but was caught before it was given. What should be done?

1. ATell only the patient's family
2. BDiscipline the nurse who prepared it on the spot in front of colleagues
3. CReport it as a near miss through the incident reporting system
4. DSay nothing, because no harm reached the patient

A patient with a long QT interval develops a polymorphic ventricular tachycardia that twists around the baseline but still has a pulse. Which drug is used first?

1. AIntravenous adenosine
2. BIntravenous potassium chloride as a bolus
3. CIntravenous magnesium sulfate
4. DOral digoxin

بعد ثلاثة أسابيع من احتشاء عضلة القلب، يعاني مريض حمى وألم صدر جنبيًا يخف بالانحناء إلى الأمام واحتكاكًا تامّوريًا. أيّ حالة هي الأرجح؟

1. Aتسلخ الأبهر الحاد
2. Bمتلازمة ما بعد الاحتشاء (متلازمة دريسلر)
3. Cاحتشاء STEMI جديد في شريان آخر
4. Dقصور البطين الأيسر الحاد

How does the nurse test the facial nerve (VII)?

1. ATouch the forehead, cheek and chin with cotton wool
2. BAsk them to raise the eyebrows, shut the eyes tightly and smile
3. CShine a light in each eye and check the pupil response
4. DAsk the patient to stick out the tongue and move it from side to 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. AIgnore it, because it shows that the patient is seeking attention from the staff
2. BTell the patient that crying will slow their recovery
3. CExplain that this is emotional lability after stroke and help the family understand
4. DAsk the doctor for a sedative to stop the outbursts

ما معدات الوقاية الشخصية الموصى بها عادةً عند إعطاء العلاج الكيميائي السام للخلايا؟

1. Aقفازات مختبَرة للعلاج الكيميائي وثوب غير منفذ
2. Bقفازات قطنية عادية ومئزر بلاستيكي
3. Cكمامة جراحية ورقية دون قفازات
4. Dلا معدات وقاية، لأن كيس التسريب مغلق

A patient with gastric outlet obstruction has vomited repeatedly for several days. Which blood picture is most likely?

1. ALow chloride, low potassium and metabolic alkalosis
2. BNormal electrolytes with respiratory alkalosis
3. CHigh chloride, high potassium and metabolic acidosis
4. DHigh calcium, high sodium and respiratory acidosis