تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

After a hip replacement using a posterior approach, which statement shows a need for further teaching?

1. A“I will keep a pillow between my knees when I lie on my side in bed.”
2. B“I will not bend my hip past 90 degrees.”
3. C“I will cross my legs when I sit, so I am more comfortable.”
4. D“I will use a raised toilet seat at home.”

A nurse has a needlestick injury from a used needle. What should the nurse do first?

1. AFinish the shift and report it tomorrow
2. BWash the area with soap and water
3. CScrub the area with bleach
4. DSqueeze the wound hard and suck it

A patient with a severe latex allergy is booked for surgery. Which measure is commonly used?

1. AGive the patient antihistamines before surgery and then use the normal supplies
2. BWrap latex items in plastic before use
3. CUse latex gloves only for short procedures
4. DUse latex-free supplies and schedule the patient as the first case of the day

A nurse has worked three long shifts in a row and feels exhausted. The manager asks the nurse to stay for another shift. What is the most appropriate response?

1. AExplain that fatigue would make care unsafe and decline the extra shift
2. BAgree without telling anyone about the fatigue
3. CAgree and drink extra coffee to stay alert
4. DAgree, but skip the independent medication checks to save energy on the shift

A patient with hyperkalemia is prescribed an oral potassium binder such as patiromer or sodium zirconium cyclosilicate. How does this drug lower potassium?

1. AIt stops the kidneys from absorbing water in the tubules
2. BIt protects the heart muscle against high potassium levels
3. CIt moves potassium into cells in the next few minutes
4. DIt binds potassium in the gut so it leaves in the stool

A 68-year-old man has fatigue, a hemoglobin of 9,8 g/dL (98 g/L), an MCV of 72 fL and a low ferritin. He eats a normal diet. What is the most important next step?

1. ALook for a source of blood loss in the gut
2. BStart vitamin B₁₂ injections
3. CRepeat the blood count in one year
4. DGive iron and do no further tests at all

A very anxious patient breathes rapidly for a long period. Which change is expected?

1. ARespiratory alkalosis from a low PaCO₂
2. BRespiratory acidosis from a high PaCO₂
3. CMetabolic alkalosis from vomiting
4. DMetabolic acidosis from a low bicarbonate

كان إخراج البول لدى مريض منخفضًا جدًا لمدة 12 ساعة وارتفع الكرياتينين بشدة. أي دواء في المخطط هو الأرجح أن يحتاج إلى مراجعة؟

1. Aمكمّل فيتامينات
2. Bكريم مرطّب
3. Cدواء مضاد للالتهاب غير ستيرويدي مثل إيبوبروفين
4. Dالباراسيتامول بالجرعات المعتادة

A patient with an implantable cardioverter-defibrillator asks what to do if it fires. Which teaching is correct?

1. AIgnore any shock at all, because the device is designed to fire every day and needs no follow-up
2. BRemove the device battery at home if it fires more than once
3. COne shock and well: contact the device clinic; repeated shocks or unwell: call emergency services
4. DDrive straight to hospital alone after any shock so the device can be checked by the team

Thirty minutes after extubation, a patient develops a high-pitched noise on breathing in and is anxious. SpO₂ is falling. What should the nurse do?

1. AEncourage the patient to sleep it off and recheck them in an hour
2. BLay the patient flat and reassure them
3. CGive a large drink of cold water to soothe the throat and settle it
4. DSit the patient up, give oxygen and call for urgent airway help

After a kidney biopsy, which observation is most important?

1. ASigns of bleeding, such as haematuria and a rising pulse
2. BThe colour of the patient's skin on the face
3. CThe patient's appetite at the next meal
4. DThe temperature every four hours only

A prescription reads "Insulin 10U". Why is this a safety problem?

1. AThere is no problem as long as the nurse can read it
2. BInsulin doses must always be written in millilitres
3. C"U" can be misread as a zero, giving a tenfold dose
4. D"U" means the insulin must be given intravenously

مريض نزف السبيل الهضمي العلوي الحاد هيموغلوبينه طبيعي عند الوصول. لماذا قد يكون ذلك مضللًا؟

1. Aلأن الهيموغلوبين يرتفع دائمًا في البداية بعد أي فقد دم
2. Bلأنه ينخفض فقط بعد انتقال السوائل أو تخفيف الدم بالسوائل الوريدية
3. Cلأن الهيموغلوبين لا ينخفض إلا بعد أسبوع كامل من النزف المتواصل
4. Dلأن الهيموغلوبين لا يتأثر بالنزف من الأمعاء

A patient arrives in the anaesthetic room without an identity band. What should the nurse do?

1. AStop and confirm identity, then apply a band
2. BProceed because the patient can say their name
3. CUse the spare identity band from the front of the patient's notes folder
4. DProceed and add a band once in recovery