تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

Straight after birth, what is the first priority for a healthy-looking newborn?

1. ADry and warm the baby while checking that it is breathing
2. BWeigh and measure the baby on the scale
3. CGive the vitamin K injection before anything else is done
4. DGive the first bath to remove the blood and vernix

Which patient with cirrhosis should the nurse see first?

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

A patient is on suicide precautions. Which room safety measure is appropriate?

1. AKeep the door closed at all times so the patient has privacy
2. BAllow glass bottles if the patient seems calm
3. CRemove items that could be used for self-harm, such as belts and cords
4. DLet the patient keep a personal razor for shaving, as long as staff are told

A patient with a common cold asks for antibiotics “to be on the safe side”. Which response is best?

1. AExplain that antibiotics do not work on viruses and overuse breeds resistant bacteria
2. BSuggest using leftover antibiotics from a previous illness
3. CTell the patient that antibiotics will shorten the cold by several days
4. DAsk the provider to prescribe antibiotics anyway so that the patient is reassured

A healthy patient has a mildly raised CK after running a marathon yesterday, without dark urine or symptoms. What is the most likely explanation?

1. AAn acute myocardial infarction has occurred
2. BThe patient has developed acute hepatitis
3. CThe patient has developed acute pancreatitis
4. DStrenuous exercise raised CK from skeletal muscle

A patient with cirrhosis and ascites has fever and abdominal tenderness. The ascitic fluid neutrophil count is 400 cells/mm³. What does this indicate?

1. AMalignant ascites from cancer
2. BBleeding into the abdominal cavity
3. CSpontaneous bacterial peritonitis
4. DNormal ascitic fluid in cirrhosis

In UK guidance, neutropenic sepsis is commonly defined by a temperature above 38 °C or signs of sepsis with a neutrophil count at or below:

1. A150 × 10⁹/L
2. B0,5 × 10⁹/L
3. C15 × 10⁹/L
4. D5 × 10⁹/L

لماذا لا يجوز أبدًا إعطاء كلوريد البوتاسيوم المركّز حقنًا وريديًا سريعًا؟

1. Aلأنه يسبب فشلًا كلويًا فوريًا
2. Bلأنه يتبلور في الوريد ويسد القنية
3. Cلأنه قد يسبب اضطرابات نظم قلبية قاتلة
4. Dلأنه لا يؤثر إذا أُعطي بسرعة

How is a patient usually positioned for a thoracentesis?

1. ALying on the affected side with the head down
2. BSitting upright and leaning forward over a table
3. CFlat on the back with the legs raised
4. DProne with the arms by the sides

مريض موصول بجهاز تنفس صناعي في العناية المركزة معرَّض لخطر الالتهاب الرئوي المرتبط بالتهوية. أيّ إجراء تمريضي يقلّل هذا الخطر؟

1. Aإبقاء رأس السرير مرفوعًا بزاوية 30–45°
2. Bتغيير أنابيب جهاز التنفس كل بضع ساعات
3. Cإبقاء المريض مسطحًا لحماية الأنبوب الرغامي
4. Dتجنب العناية بالفم لمنع نزف اللثة

بعد إصابة في الرأس، يقطر سائل صافٍ من أنف المريض. ما القلق الرئيسي؟

1. Aمخاط طبيعي ينتج بعد البكاء
2. Bتسرب سائل دماغي شوكي بسبب كسر في الجمجمة
3. Cزكام بسيط أو نوبة حمى القش
4. Dتفاعل تحسسي مع مادة التباين في التصوير المقطعي

A patient with a cervical spinal cord injury is helped to sit up for the first time. They become dizzy and pale, and the BP falls from 110/70 to 78/46 mmHg. What should the nurse do?

1. ALower the patient back towards lying, then raise them gradually later
2. BStand the patient up to improve the blood flow to the legs
3. CGive a large meal and a strong coffee to raise the blood pressure
4. DContinue sitting them upright, because it will pass in an hour

Why does a patient need lifelong vitamin B₁₂ injections after total gastrectomy?

1. AIntrinsic factor from the stomach is no longer made
2. BThe liver can no longer store any vitamins
3. CVitamin B₁₂ is lost in the urine after the surgery
4. DThe small bowel stops absorbing all nutrients

During radiotherapy to the chest, a patient develops pain on swallowing and is eating less. What is the most likely cause and nursing focus?

1. ARadiation oesophagitis; analgesia, soft food and nutrition support
2. BNormal ageing; no action needed
3. CA heart attack; give aspirin and arrange an ECG
4. DA stomach ulcer; give an antacid after meals only