تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

Which patient is at the highest risk of falling?

1. AAn 84-year-old taking a diuretic who has fallen before and gets up at night
2. BA 30-year-old after an appendectomy who walks with steady steps
3. CA 45-year-old with asthma who is alert and independent
4. DA 60-year-old admitted for chest pain that has since been ruled out by tests

A nurse sees a colleague put a vial of an opioid into their own pocket instead of returning it. What should the nurse do?

1. AAsk the colleague to share the vial with them
2. BTell the patients to watch the colleague carefully
3. CSay nothing, because it is not their business
4. DReport it to the nurse manager according to policy

أيّ نفايات الضمادات ينبغي التخلص منها في النفايات السريرية (الخطرة بيولوجيًا)؟

1. Aمنشفة ورقية نظيفة استُخدمت لتجفيف اليدين
2. Bضماد غير مستخدم ما زال مغلقًا انتهت صلاحيته
3. Cضماد مشبع بسائل من جرح مصاب بعدوى
4. Dالغلاف الورقي الخارجي لعبوة ضمادات معقمة

أيّ اقتران بين كائن ممرض واحتياطات الانتقال الخاصة به صحيح؟

1. Aالإنفلونزا – الانتقال عبر الهواء فقط
2. Bالنكاف – الرذاذ
3. Cالحصبة – التلامس فقط
4. DC. difficile – الانتقال عبر الهواء

تعداد الكريات البيضاء لدى مريض 16 × 10³/µL مع نسبة عالية من العدلات غير الناضجة (الأشرطة bands). على ماذا يدل ذلك على الأرجح؟

1. Aمرض فيروسي مزمن فقط
2. Bنتيجة طبيعية
3. Cفقر دم نقص الحديد
4. Dعدوى جرثومية حادة

A patient with diabetes and chronic kidney disease had a CT scan with IV contrast. Two days later, the creatinine has risen from 1,4 to 2,0 mg/dL (124 to 177 µmol/L). Which action is most appropriate?

1. AIgnore it, because contrast never affects kidney function
2. BGive extra metformin, because the glucose rises after contrast
3. CRestrict all fluids to protect the kidneys from more contrast
4. DReport it, monitor urine output and hold metformin until reviewed

Why is lactulose given to a patient with hepatic encephalopathy?

1. ATo stop bleeding from varices
2. BTo increase the liver's production of albumin
3. CTo reduce the absorption of ammonia from the gut
4. DTo lower the blood glucose

A nurse realises she has given a patient a medicine prescribed for another patient. What should she do first?

1. AWait to see whether any side effects develop
2. BGive the patient's own medicine as well to balance it
3. CAsk a colleague not to mention it
4. DCheck the patient's condition and inform the doctor

Why is a beta-blocker started at a low dose and increased slowly in heart failure?

1. AIt works only if the dose is never changed after the first day
2. BIt must be stopped as soon as symptoms improve
3. CIt is safe only at the highest possible dose from the very start
4. DIt can briefly worsen symptoms before long-term benefit appears

An older ex-smoker has a dry cough and worsening breathlessness over a year, finger clubbing and fine "Velcro-like" crackles at both bases at the end of inspiration. Which condition is most likely?

1. ASpontaneous pneumothorax
2. BAn acute asthma attack
3. CIdiopathic pulmonary fibrosis
4. DCommunity-acquired pneumonia

مريض مصاب بـ AKI لديه قسطرة بولية لا تصرّف شيئًا. أيّ فحص سريع عند السرير يساعد على استبعاد سبب بعد كلوي؟

1. Aتشجيع المريض على شرب لترين من الماء
2. Bإرسال عينة بول للزرع وانتظار نتيجة المختبر
3. Cإعطاء جرعة كبيرة من السوائل الوريدية فورًا
4. Dفحص القسطرة بحثًا عن التواءات أو انسداد وإجراء مسح للمثانة

Which statement correctly distinguishes spinal shock from neurogenic shock?

1. ASpinal shock is low blood pressure; neurogenic shock is the loss of reflexes
2. BNeurogenic shock is caused by blood loss; spinal shock is caused by infection
3. CThey are two names for exactly the same condition
4. DSpinal shock is lost reflexes; neurogenic shock is low BP and slow pulse

Which risk is particularly linked with tramadol?

1. ASevere stomach ulcers in all patients
2. BRapid liver failure at normal doses
3. CHigh blood pressure that needs emergency treatment in most patients
4. DSerotonin syndrome with some antidepressants, and seizures

A patient who takes NSAIDs suddenly develops severe epigastric pain, a rigid abdomen and shoulder-tip pain. Which finding would most support the likely diagnosis?

1. AFluid levels in the bladder on an ultrasound scan
2. BFree air under the diaphragm on an erect chest X-ray
3. CA raised serum lipase three times the upper limit
4. DTall, peaked T waves on a 12-lead ECG