تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A drowsy patient has an arterial blood gas with pH 7,30, PaCO₂ 58 mmHg (7,7 kPa) and HCO₃⁻ 25 mEq/L (mmol/L). Which problem is the priority?

1. ALoss of bicarbonate from the bowel through severe diarrhea
2. BPoor ventilation causing carbon dioxide to build up
3. CHyperventilation caused by anxiety
4. DToo much bicarbonate from antacids

A child is admitted with a suspected Wilms tumor (nephroblastoma). Which instruction is most important for all staff?

1. AMeasure abdominal girth by pressing firmly
2. BGive a warm bath with abdominal massage
3. CEncourage the child to play contact sports
4. DDo not palpate the abdomen

Before a blood transfusion is started, which check is required?

1. AThe patient signs the blood bag label to confirm their name before it is hung
2. BThe patient’s identity is checked against the blood product and its paperwork at the bedside
3. CThe nurse checks only that the bag number matches the order
4. DOne nurse checks the blood product against the order at the nurses’ station

A small-bore feeding tube has just been inserted blindly at the bedside. Which method is the most reliable way to confirm its position before the first feeding?

1. ABy an x-ray reviewed by a competent clinician
2. BBy putting the end in water to look for bubbles
3. CBy checking that the patient can still talk
4. DBy listening over the stomach while injecting air

A patient has a hot, swollen big toe. The serum uric acid is normal. Which statement is correct?

1. AGout is ruled out, as uric acid is always high in an attack
2. BGout can only be diagnosed with a CT scan of the foot
3. CGout is still possible, as urate can be normal in an attack
4. DGout is certain, as a normal urate proves the diagnosis

بعد العلاج الكيميائي لورم لمفي سريع النمو، أي نمط من النتائج يوحي بمتلازمة انحلال الورم؟

1. Aبوتاسيوم منخفض وفوسفات منخفض وحمض بولي منخفض وكالسيوم مرتفع
2. Bشوارد طبيعية مع هيموغلوبين عالٍ
3. Cصوديوم عالٍ وغلوكوز منخفض فقط
4. Dبوتاسيوم عالٍ وفوسفات عالٍ وحمض بولي عالٍ وكالسيوم منخفض

Which side effect is common when a patient starts taking metformin?

1. AHypoglycaemia in most patients who take it
2. BNausea, abdominal discomfort or diarrhoea
3. CSevere headache
4. DRapid weight gain

A nurse teaches a patient with diabetes about foot care. Which statement shows a need for further teaching?

1. A"I will wear well-fitting shoes."
2. B"I will see the podiatrist about hard skin."
3. C"I will check my feet every day for cuts or blisters."
4. D"I will walk barefoot at home to toughen my feet."

A patient has just started an ACE inhibitor. Which blood tests are usually checked within the first one to two weeks?

1. AINR and platelet count
2. BTroponin and creatine kinase
3. CLiver enzymes and amylase
4. DPotassium and creatinine

Which task for a stable patient with heart failure can the registered nurse most appropriately delegate to a healthcare assistant (unlicensed assistive personnel)?

1. AAssessing lung sounds for new crackles
2. BMeasuring and recording the morning weight
3. CDeciding whether to give the furosemide dose
4. DTeaching the patient about a low-salt diet

How do DPP-4 inhibitors such as sitagliptin work?

1. AThey block glucose reabsorption in the kidney
2. BThey stop the gut from absorbing fat
3. CThey prolong the action of gut incretin hormones
4. DThey replace insulin that the pancreas cannot make

A patient with CKD has a potassium of 6,5 mmol/L. Which medicine combination is the most likely contributor?

1. AFurosemide, salbutamol and insulin
2. BRamipril, spironolactone and trimethoprim
3. CAmlodipine, simvastatin and aspirin
4. DParacetamol (acetaminophen), omeprazole and senna

Before an anti-TNF biologic such as infliximab is started for Crohn's disease, which screening is essential?

1. AA test of colour vision
2. BA test for coeliac disease
3. CScreening for tuberculosis
4. DA bone density scan

A patient with diabetes has rapidly spreading redness around a small wound, severe pain out of proportion, fever and crackling under the skin. What should the nurse suspect?

1. ANecrotising fasciitis
2. BA simple insect bite
3. CMild contact dermatitis
4. DA healing venous ulcer