تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

ممرضة تعمل عادةً في التوليد تُنقل مؤقتًا إلى وحدة طبية للبالغين. أي مريض هو الأنسب لإسناده إلى هذه الممرضة؟

1. Aمريض لديه فغر رغامي جديد
2. Bمريض ذات رئة مستقر على مضادات حيوية فموية
3. Cمريض على تسريب إنسولين مستمر للحماض الكيتوني السكري
4. Dمريض لديه نزف نشط في الجهاز الهضمي العلوي

Using ESI, a stable adult with abdominal pain will need blood tests and a CT scan, but has a heart rate of 130/min. Which statement is correct?

1. AThe patient is level 5 because the pain is not severe
2. BThe nurse should consider level 2 because of the danger-zone vital sign
3. CVital signs never change the ESI level
4. DThe patient is level 4 because the blood tests and the scan count as one resource

Before inserting a peripheral IV, the nurse cleans the skin with chlorhexidine-alcohol. What should the nurse do next?

1. ALet it dry fully and do not touch the site again
2. BWipe it off with a dry gauze straight away
3. CBlow on the site so it dries faster
4. DFeel for the vein again with an ungloved finger

A patient on long-term high-dose corticosteroids asks for the nasal spray influenza vaccine. What should the nurse explain?

1. AEither type is fine, as long as it is given in the morning
2. BThe nasal spray is a live vaccine, so the injected inactivated vaccine is used instead
3. CPeople on steroids should never have any influenza vaccine
4. DThe nasal spray is the best choice for people on steroids, because it is not injected

A patient is starting atorvastatin. Which laboratory test is usually checked at baseline?

1. AThyroid antibodies
2. BBlood cultures
3. CLiver enzymes
4. DSerum lipase

A patient with a round face, central weight gain and purple stretch marks has a glucose of 210 mg/dL (11,7 mmol/L) and a potassium of 3,1 mEq/L. Which condition fits best?

1. AAdrenal insufficiency
2. BCushing syndrome
3. CDiabetes insipidus
4. DHypothyroidism

After a laparoscopic cholecystectomy, a patient has pain in the shoulder tip. What is the most likely cause?

1. AA heart attack caused by the stress of surgery
2. BGas used during the operation irritating the diaphragm
3. CA broken collarbone from being moved onto the table
4. DAn allergic reaction to the dressing

A patient has a single hot, swollen, very painful knee and a fever. Why is urgent joint aspiration important?

1. ATo rule out septic arthritis, which can rapidly destroy the joint
2. BTo measure the patient's cholesterol
3. CTo prevent osteoporosis
4. DTo check for rheumatoid arthritis antibodies in the joint fluid

A patient with diabetes is starting a beta-blocker. What should the nurse teach about hypoglycaemia?

1. AThe beta-blocker will prevent all episodes of hypoglycaemia
2. BSome warning signs, such as a fast heartbeat, may be masked
3. CInsulin should be stopped while taking a beta-blocker
4. DHypoglycaemia will always cause a very slow and weak pulse

A patient with a stab wound to the chest has a hole that sucks air with each breath. What is the immediate management?

1. APack the wound tightly with gauze pushed deep into the chest
2. BSeal it completely with tape on all four sides and leave it alone
3. CLeave it open and give a nebuliser
4. DCover it with a vented chest seal or a dressing taped on three sides

A patient with migraine takes painkillers or triptans on most days and now has a headache almost every day. What is the likely problem?

1. ANormal progress of migraine
2. BA brain tumour, which is almost certain
3. CAn allergy to the painkillers
4. DMedication overuse headache

A patient with stable epilepsy on phenytoin started a new medicine last week. They now have nystagmus, an unsteady gait and slurred speech. What should the nurse do?

1. ASuspect phenytoin toxicity, hold the next dose and ask for a drug level
2. BEncourage the patient to walk more to improve their balance
3. CGive the next phenytoin dose early to prevent a seizure
4. DSuspect a new stroke and give aspirin straight away before any scan

Which technique is correct when giving a prefilled low molecular weight heparin injection?

1. ALeave the air bubble in and inject into a skin fold
2. BInject into a vein in the back of the hand
3. CRub the site firmly afterwards to help absorption
4. DExpel the air bubble first and inject into the deltoid muscle

A patient has an implanted port for chemotherapy. Which needle is used to access it?

1. AA standard hollow needle used for venepuncture
2. BAn intramuscular injection needle
3. CA wide-bore cannula with a steel stylet
4. DA non-coring (Huber) needle