تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A nurse teaches a patient about levothyroxine. Which statement shows a need for further teaching?

1. A“I will keep taking it even when I feel well.”
2. B“I will take it at the same time each morning.”
3. C“I will take it on an empty stomach with a glass of water.”
4. D“I will take it at breakfast with my calcium tablet.”

Which finding most suggests a tension pneumothorax rather than a simple pneumothorax?

1. AMild breathlessness with reduced breath sounds on one side of the chest only
2. BA small air leak seen on a routine chest X-ray
3. CSharp chest pain that is worse on deep breathing
4. DTrachea shifted away from the affected side, with low blood pressure

During a surgical hand scrub, how are the hands held?

1. ABelow the elbows, so water runs off the fingertips into the sink
2. BPointing downward into the sink at all times
3. CAbove the elbows, so water runs from the fingertips toward the elbows
4. DAt the level of the waist, close to the body

A nurse teaches a patient with active pulmonary tuberculosis who is going home on treatment. Which statement shows a need for further teaching?

1. A“I can stop taking the pills once I feel better.”
2. B“I will need to take my medicines for several months.”
3. C“I will come back for sputum tests as planned.”
4. D“I will cover my mouth with a tissue when I cough.”

A patient with chronic kidney disease has a magnesium of 3,8 mEq/L (1,9 mmol/L). Which product is the most likely cause?

1. ALoop diuretics such as furosemide
2. BProton pump inhibitors taken long term
3. CExcess alcohol use over many years
4. DMagnesium-containing laxatives or antacids

أثناء تسريب كبريتات المغنيزيوم الوريدي، أي تقييم يكشف السمية مبكرًا على أفضل وجه؟

1. Aمنعكسات الركبة ومعدل التنفس وكمية البول
2. Bسكر الدم وحجم الحدقة كل ساعة
3. Cأصوات الأمعاء ومحيط البطن
4. Dلون الجلد وزمن عودة امتلاء الشعيرات كل ساعة

لماذا يُقاس اللاكتات في المصل لدى مريض يُشتبه بإصابته بالإنتان؟

1. Aلأن ارتفاع اللاكتات يدل على ضعف تروية الأنسجة وعلى خطر أعلى
2. Bلأنه يقيس سكر الدم لدى المريض
3. Cلأنه يبيّن ما إذا كان لدى المريض عدوى في المسالك البولية
4. Dلأنه يحدد المضاد الحيوي الذي يجب إعطاؤه

A catheterised postoperative patient has passed only 10 mL of urine in the last two hours. What should the nurse check first?

1. AWhether the patient has eaten breakfast
2. BThe patient's cholesterol level from the admission bloods
3. CThat the catheter and tubing are not kinked or blocked
4. DThe patient's weight from last year

A patient is starting doxazosin, an alpha-blocker, for hypertension. Which advice is most important?

1. AStop it suddenly if the heart rate rises after the first few doses
2. BAvoid all potassium-containing foods
3. CTake it with a large glass of grapefruit juice to improve absorption
4. DTake the first dose at bedtime, as dizziness and fainting can occur

مريض لديه ألم صدر مع ارتفاع ST في الاشتقاقات II وIII وaVF. الضغط 86/54 mmHg، والرئتان سليمتان، والأوردة العنقية متوسعة. أيّ دواء موصوف ينبغي أن تستفسر عنه الممرضة؟

1. Aالأكسجين إذا انخفض SpO₂ دون الهدف
2. Bالأسبرين 300 mg مضغًا
3. Cثلاثي نترات الغليسريل تحت اللسان
4. Dمضاد قيء وريدي

A patient with type 1 diabetes has gastroenteritis and cannot eat. Which sick-day advice is correct?

1. AKeep taking basal insulin and check glucose and ketones more often
2. BCheck glucose once a day only and rest in bed until better
3. CStop all insulin until normal eating restarts
4. DAvoid drinking fluids to reduce the vomiting

The nurse has four renal patients. Which one needs to be seen first?

1. AA patient with a creatinine slightly above their usual level
2. BA patient with mild itching from uraemia who wants a cream
3. CA patient with CKD asking about their phosphate binder
4. DA patient with a potassium of 6,8 mmol/L who reports palpitations

Which practice is correct when giving parenteral nutrition through a central line?

1. AGive other IV drugs through the same lumen to save time
2. BUse a dedicated lumen and strict aseptic technique
3. CLet the bag hang at room temperature for several days
4. DDisconnect and reconnect the line without cleaning the hub

A patient with a severe flare of ulcerative colitis develops abdominal distension, fever and tachycardia, and the stool frequency has dropped. What should the nurse suspect?

1. AToxic megacolon
2. BHaemorrhoids caused by diarrhoea
3. CSimple constipation from low intake
4. DThe flare is getting better