تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

أثناء فرز START، بالغ لا يستطيع المشي يتنفس 36 مرة في الدقيقة. أي فئة يُعطاها؟

1. Aأخضر (طفيف)
2. Bأحمر (فوري)
3. Cأصفر (مؤجَّل)
4. Dأسود (متوقَّع)

ترى ممرضة أن جرعة موصوفة غير آمنة. يقول الواصف أن تعطيها على أي حال. ماذا ينبغي أن تفعل الممرضة؟

1. Aإعطاء نصف الجرعة حلًّا وسطًا وتوثيق السبب
2. Bحجب الجرعة والتصعيد عبر التسلسل الإداري
3. Cإعطاء الجرعة، لأن الواصف أصبح مسؤولًا عنها
4. Dتخطي الجرعة بصمت وعدم قول شيء لتجنب الخلاف

A patient has a very low platelet count. Which safety measure is appropriate?

1. AUse a firm toothbrush and a safety razor
2. BFloss hard each day to keep the gums healthy
3. CUse a soft toothbrush and an electric razor
4. DTake rectal temperatures for accuracy

A patient’s allergy band says “penicillin”, and an order has been written for amoxicillin. What should the nurse do?

1. AGive an antihistamine first and then the drug
2. BGive the drug and watch the patient closely
3. CAsk the patient whether they would like to take it anyway
4. DHold the drug and contact the prescriber

A patient with central diabetes insipidus starts desmopressin. Which laboratory result is most important to monitor for an adverse effect?

1. ASerum calcium, which may rise too high
2. BSerum potassium, which may rise too high
3. CSerum sodium, which may fall too low
4. DSerum glucose, which may rise very high

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. CReport it, monitor urine output and hold metformin until reviewed
4. DRestrict all fluids to protect the kidneys from more contrast

Which mask is required for staff during an aerosol-generating procedure on a patient with a respiratory infection spread by aerosols?

1. AA fit-tested respirator mask (such as FFP3 or N95)
2. BNo mask, as long as gloves are worn
3. CA cloth face covering
4. DA standard fluid-repellent surgical mask with a visor

A patient with type 1 diabetes is nil by mouth before surgery. Why must their insulin not simply be stopped?

1. AStopping insulin causes immediate hypoglycaemia during the operation
2. BInsulin prevents wound infection on its own
3. CWithout any insulin they can develop diabetic ketoacidosis
4. DInsulin is needed for the anaesthetic to work

The telemetry monitor suddenly shows a chaotic waveform resembling ventricular fibrillation, but the patient is talking and brushing their teeth. What should the nurse do first?

1. ACheck the patient and the electrodes, as this is likely artefact
2. BDeliver an immediate defibrillation shock before checking anything
3. CGive IV amiodarone as a bolus
4. DStart chest compressions straight away and call the arrest team

تخطط ممرضة لرعاية أربعة مرضى. أيّ مريض ينبغي تقييمه أولًا؟

1. Aمريض قصور قلب مستقر ينتظر وزنه اليومي
2. Bمريض COPD انخفض SpO₂ لديه من 90% إلى 83% مع نعاس جديد
3. Cمريض بارتفاع ضغط مضبوط يسأل عن الملح
4. Dمريض بقرحة وريدية حان موعد تغيير ضمادها

During continuous bladder irrigation, 3200 mL drains out in a shift. 2500 mL of irrigation fluid was put in. What is the true urine output?

1. A3200 mL
2. B2500 mL
3. C700 mL
4. D5700 mL

A student has fever, a severe headache, a spreading non-blanching rash and a BP of 85/50 mmHg. A lumbar puncture is planned. What is the priority?

1. AGive paracetamol (acetaminophen) and recheck observations in an hour
2. BGive IV antibiotics at once and start sepsis treatment
3. CWait until after the lumbar puncture before giving antibiotics
4. DArrange a CT scan of the head before any treatment

Which statement correctly describes physical dependence on opioids?

1. AThe drug no longer has any side effects
2. BWithdrawal occurs if the drug is stopped suddenly
3. CThe patient is allergic to opioids
4. DThe patient always craves the drug and misuses it despite harm

أيّ استراتيجية للسوائل يوصى بها عمومًا في الساعات الأولى من التهاب البنكرياس الحاد؟

1. Aألبومين وريدي وحده بدل أي محلول بلّوري
2. Bمحلول بلّوري متوازن موجّه بالهدف، يوجَّه بالاستجابة
3. Cأحجام كبيرة جدًا مهما كانت استجابة المريض
4. Dلا سوائل وريدية إطلاقًا، فقط رشفات صغيرة من الماء الفموي