تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A nurse teaches a patient who uses crutches. Which statement shows a need for further teaching?

1. A“I will keep the crutch tips in good condition.”
2. B“I will remove loose rugs from the floor at home.”
3. C“I will take my weight on my hands, not on my armpits.”
4. D“I will lean on the crutch pads under my arms to rest.”

Which patient with cirrhosis should the nurse see first?

1. ALarge ascites that is unchanged from yesterday
2. BVomiting bright red blood, heart rate 120/min
3. CLong-standing jaundice and itchy skin, asking for cream
4. DWants to talk about stopping drinking alcohol for good

What is the main aim of purposeful hourly rounding?

1. ATo replace the need for a call light
2. BTo count the patient’s medications every hour and check that none are missing
3. CTo check pain, toileting, position and personal items before the patient needs to ask
4. DTo wake the patient every hour to check orientation

أصيب مريض بالمكورات العنقودية الذهبية المقاومة للميثيسيلين (MRSA) في جرح ويحتاج الآن إلى تغيير ضماد. أيّ معدات وقاية شخصية مناسبة؟

1. Aلا معدات وقاية، إذا نُظّفت اليدان بعد ذلك
2. Bثوب وقفازات، مع حماية للعينين وكمامة إذا كان الرذاذ المتطاير مرجّحًا
3. Cكمامة N95 تنفسية فقط، لأن MRSA كائن مقاوم
4. Dقفازات معقمة فقط، دون ثوب أو حماية أخرى

A patient with sickle cell disease takes hydroxyurea. Which laboratory test is monitored regularly for an adverse effect?

1. AUrine ketone level
2. BComplete blood count
3. CSerum amylase level
4. DSerum lithium level

A patient has a hematocrit of 60% and a raised red cell mass. Which result suggests polycythemia vera rather than secondary polycythemia from chronic hypoxia?

1. AA high carboxyhemoglobin
2. BA high erythropoietin level
3. CA low erythropoietin level
4. DA low oxygen saturation

Which side effect of regular opioids usually needs preventive treatment from the start?

1. ADiarrhoea
2. BConstipation
3. CHigh blood pressure
4. DExcessive hunger

A patient is recognised by the team as being in the last days of life. Which approach is correct?

1. AReview and stop treatments that no longer help, and focus on comfort
2. BAvoid talking with the family about what is happening
3. CStop all medicines, including pain relief and anti-sickness drugs
4. DContinue all routine blood tests and observations four-hourly

A patient in cardiac rehabilitation asks how hard to exercise. Which simple guide is commonly taught?

1. AExercise until they are too breathless to speak at all
2. BExercise only until the heart rate rises even slightly
3. CExercise until chest pain starts, then stop
4. DExercise so they are a little breathless but can still talk

During tracheal suctioning, a patient's heart rate drops from 88/min to 48/min. What should the nurse do?

1. AContinue suctioning until the airway is completely clear
2. BGive a dose of atropine without a prescription
3. CStop suctioning, give oxygen and monitor the patient
4. DIncrease the suction pressure to finish faster

An 85-year-old care home resident becomes newly confused and is falling more often. A UTI is one possibility. Why?

1. AUrinary infections always cause a high fever in older adults
2. BA UTI cannot occur in people over 80
3. CConfusion is the only symptom of a UTI at any age
4. DOlder adults often show infection as confusion

Four patients had a minor head injury with no loss of consciousness and a GCS of 15. Which one most needs a CT scan of the head?

1. AA 78-year-old who takes warfarin for atrial fibrillation
2. BA 30-year-old who bumped their head on a cupboard door
3. CA 25-year-old with a small scalp graze after a fall
4. DA 40-year-old with a mild headache that is improving

Which patient is at highest risk of refeeding syndrome?

1. AA patient with a normal BMI eating three meals a day
2. BA healthy adult after an overnight fast for minor surgery
3. CAn underweight patient who has eaten very little for 10 days
4. DA patient who missed one lunch because of a scan

A nurse finds a dislodged sealed radiation source in the bed of a patient receiving brachytherapy. What should the nurse do?

1. APick it up with gloved hands and put it in the nearest sharps bin quickly
2. BUse long-handled forceps to put it in the lead container; report it
3. CLeave it in the bed until the end of the shift
4. DThrow it in the clinical waste bag