تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A patient taking lithium has vomiting, diarrhea and a new coarse tremor. What should the nurse do?

1. AEncourage the patient to cut down on salt and fluids
2. BHold the next dose and report for an urgent lithium level
3. CGive the dose with food to reduce the stomach upset
4. DReassure the patient that a coarse tremor is expected at first

An adult has burns over 40% of the body with no signs of airway injury. Which treatment is the priority during the first hours?

1. AApplying antibiotic cream to all the burns before anything else
2. BStarting physiotherapy to prevent contractures straight away
3. CLarge-volume IV fluids with close monitoring of urine output
4. DGiving a high-protein meal to support healing

تعرضت ممرضة لوخز إبرة من مريض معروف إصابته بفيروس العوز المناعي البشري (HIV). لماذا من المهم الإبلاغ فورًا؟

1. Aلأنه يمكن الإبلاغ في أي وقت خلال شهر دون أن يتغير الخطر
2. Bلأن الإبلاغ مطلوب فقط إذا نزف الجرح أو كان عميقًا
3. Cلأن الوقاية بعد التعرض تكون أنجع عند بدئها خلال ساعات
4. Dلأن الإبلاغ مطلوب فقط عن الإصابات بإبر الحقن الوريدي

وُصف للمريض الهيدرالازين، لكن الصيدلية أرسلت الهيدروكسيزين. ماذا ينبغي أن تفعل الممرضة؟

1. Aإعطاء نصف جرعة الهيدروكسيزين حلًّا وسطًا
2. Bعدم إعطائه، والاتصال بالصيدلية للحصول على الدواء الصحيح
3. Cإعطاؤه الآن وإخبار واصف الدواء لاحقًا
4. Dإعطاؤه، لأن اسمَي الدواءين متقاربان جدًا

A patient with diabetes also takes propranolol. Why is regular glucose monitoring especially important?

1. AThe drug causes very high glucose in all patients
2. BThe drug can mask warning signs of hypoglycemia
3. CThe drug blocks the insulin injection site
4. DThe drug stops the meter from reading correctly

The nurse teaches a patient with chronic kidney disease about a potassium-restricted diet. Which statement shows a need for further teaching?

1. A"I'll limit bananas, oranges and potatoes in my meals"
2. B"I'll check food labels and ask my dietitian about portion sizes"
3. C"Dried apricots and raisins will be a good snack for me now"
4. D"I can leach potatoes by soaking them before cooking them"

Why must a patient with a new coronary stent not stop their antiplatelet medicines without specialist advice?

1. AThe stent will dissolve if the drugs are stopped before the course ends
2. BStopping causes immediate kidney failure
3. CStopping early greatly increases the risk of a clot forming in the stent
4. DStopping causes severe low blood pressure

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

1. A"I will raise the head of my bed with blocks."
2. B"A big meal just before bed is fine if I take my tablet."
3. C"I will cut down on alcohol."
4. D"I will try to lose some weight over the next months."

Which emergency equipment should be kept at the bedside of a patient with a tracheostomy?

1. AA urinary catheter set, a blood glucose meter and a thermometer
2. BA nasogastric tube and a feeding pump
3. COnly a spare oxygen mask, since the tube rarely causes problems
4. DSpare tubes (same size and one smaller), suction and oxygen

A nurse looked after a patient for a shift before smear-positive pulmonary TB was diagnosed, without wearing a respirator. What should happen?

1. AStay off work for six months in case symptoms develop
2. BReport it so occupational health can arrange follow-up screening
3. CStart a full six-month course of TB drugs at once without any tests
4. DTake no action, as healthcare workers are immune to TB

A patient on peritoneal dialysis has gained weight and has higher glucose levels. Which part of the treatment is the likely cause?

1. AGlucose absorbed from the dialysis fluid
2. BAir entering the abdomen during exchanges
3. CProtein lost into the dialysis fluid
4. DSodium lost into the dialysis fluid

مريض مصاب بالسكري من النوع 1 صائم عن الفم قبل جراحة غدًا. أيّ خطة هي الأكثر أمانًا؟

1. Aمواصلة بعض الإنسولين (قاعدي أو تسريب وريدي بمعدل متغير) مع فحوص الغلوكوز
2. Bإيقاف كل الإنسولين إلى أن يأكل المريض ويشرب بشكل طبيعي ثانية
3. Cإعطاء الإنسولين فقط إذا أصبحت كيتونات البول إيجابية بشدة ليلًا
4. Dإعطاء إنسولين وقت الوجبة المعتاد رغم عدم تناول وجبات

Which task for a stable patient with an established ileostomy can usually be delegated to a trained healthcare assistant (nursing assistant)?

1. AEmptying the pouch and measuring the output
2. BTeaching the patient about high-output risks
3. CAssessing the stoma for signs of necrosis
4. DDeciding whether IV fluids are needed

Which patient has the highest risk of postoperative nausea and vomiting?

1. AA man with no history of nausea having local anaesthetic only
2. BA smoker who has never had nausea after surgery
3. CA non-smoking woman with motion sickness who will need opioids
4. DA male smoker having a short procedure without opioids