تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

During labor, the nurse sees the umbilical cord in the vagina after the membranes rupture. What is the first action?

1. AWait for the next contraction before acting
2. BAsk the patient to walk around the room to bring the baby lower and speed up labor
3. CPush the cord back into the uterus
4. DRelieve pressure on the cord by lifting the presenting part with a gloved hand

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

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

After teaching a patient about a new medication, how does the nurse best check understanding?

1. AAsk the patient to explain in their own words how and when to take it
2. BGive a printed leaflet about the drug and assume the patient will read it at home
3. CAsk the family whether they understood the teaching
4. DAsk “Do you understand?” and accept a yes

A nurse teaches a patient with neutropenia about preventing infection at home. Which statement shows a need for further teaching?

1. A“I can clean the cat’s litter box if I wear a face mask.”
2. B“I will avoid crowds and people who have colds.”
3. C“I will wash my hands often and ask visitors to do the same.”
4. D“I will check my temperature and call if I have a fever.”

A patient with iron-deficiency anemia started oral iron. Which result is usually the earliest sign that treatment is working?

1. AA fall in the mean cell volume (MCV)
2. BA fall in the white cell count
3. CA rise in the reticulocyte count
4. DA rise in the platelet count

مريض بلا مشاكل كلوية وتخطيط قلب طبيعي، بوتاسيومه 6,2 mEq/L. يعلّق المختبر بأن العينة منحلّة (hemolyzed). ما أفضل تفسير؟

1. Aالمعالجة فورًا بالإنسولين والغلوكوز دون مزيد من الفحوص
2. Bقد تكون النتيجة مرتفعة كاذبًا؛ يُقيَّم المريض وتُرتَّب عينة جديدة
3. Cالمريض مصاب بفشل كلوي
4. Dالبوتاسيوم طبيعي بالتأكيد ولا يحتاج إلى متابعة

A nurse finds a patient lying on the floor beside the bed. What should be done first?

1. ALift the patient straight back into bed so they are comfortable
2. BPhone the patient's family
3. CCheck the patient for injuries before moving them
4. DComplete the incident report form

A patient with full mental capacity decides against a treatment that the team thinks is best. What does the Mental Capacity Act 2005 (England and Wales) say?

1. AThe family may make the decision instead if they disagree with the patient's choice
2. BThe team may override any decision that it disagrees with if it is serious
3. CThe patient must be assessed by a psychiatrist before refusing
4. DA person is not treated as lacking capacity just because they make an unwise decision

A patient has a heart rate of 36/min with hypotension and dizziness. Which drug is usually the first choice?

1. AIntravenous atropine
2. BOral bisoprolol
3. CIntravenous amiodarone
4. DIntravenous adenosine

في اليوم السادس من تسريب الهيبارين، انخفض عدد الصفيحات بأكثر من النصف ويعاني المريض ذراعًا متورمة جديدة. ماذا ينبغي أن تتوقع الممرضة؟

1. Aالتحويل إلى الهيبارين منخفض الوزن الجزيئي لأنه دواء مختلف
2. Bإيقاف كل الهيبارين وبدء مضاد تخثر لا يحتوي على الهيبارين
3. Cإيقاف كل مضادات التخثر لمدة أسبوعين
4. Dمواصلة الهيبارين ونقل صفيحات

A conscious patient with a glucose of 3,1 mmol/L (56 mg/dL) can swallow safely. Which is the best first treatment?

1. AA glass of milk and two plain biscuits
2. BA chocolate bar and a cup of tea with milk
3. CGlucose tablets or a small glass of fruit juice
4. DA dose of rapid-acting insulin with a sandwich

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

Why is thiamine given to patients with alcohol dependence admitted to hospital?

1. ATo prevent bleeding from varices
2. BTo treat the cirrhosis directly
3. CTo prevent Wernicke's encephalopathy
4. DTo reduce the craving for alcohol

A nurse teaches a patient with GORD. Which statement shows a need for further teaching?

1. A"I'll keep a diary of foods that trigger my symptoms."
2. B"Peppermint tea after dinner will settle my reflux."
3. C"I'll stop smoking because it makes reflux worse."
4. D"I'll try to lose some weight over the next months."