تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A patient has a tonic-clonic seizure in bed. What should the nurse do first?

1. APlace a tongue depressor between the teeth
2. BHold the arms and legs down firmly to stop the jerking movements quickly
3. CProtect the head and turn the patient on their side when possible
4. DGive a drink of water to help the patient wake

A nurse returns to the station to find four messages. Which one is answered first?

1. AThe pharmacy asks when the next delivery should be scheduled
2. BThe laboratory is calling with a critical potassium result of 2,6 mEq/L
3. CA colleague asks to swap shifts with them next week because of a family wedding
4. DA family member wants an update on their father’s progress

How should the urethral meatus be cared for in a patient with an indwelling urinary catheter?

1. AWith antiseptic cream applied to the meatus every shift
2. BWith routine hygiene, using soap and water during daily washing
3. CBy sliding the catheter in and out a little to clean it
4. DWith daily bladder irrigation using an antibiotic solution through the catheter

During a disaster, the hospital needs to free beds quickly. Which patient is the best candidate for early discharge?

1. AA patient on an IV heparin infusion that is still being adjusted
2. BA patient admitted overnight for observation who is now stable with normal tests
3. CA patient with ongoing chest pain awaiting cardiac tests
4. DA patient on a ventilator in the intensive care unit who is slowly improving

A healthy patient's result is slightly outside the laboratory reference range, and all other results are normal. Which statement best explains why this can happen?

1. AAny result outside the range always means disease is present
2. BReference ranges include every healthy person without exception
3. CRanges cover about 95% of healthy people, so some fall outside
4. DReference ranges are the same in every laboratory worldwide

مستوى القاع (trough) للفانكومايسين لدى مريض 28 mcg/mL؛ والهدف الذي حدده الواصف 15–20 mcg/mL. الجرعة التالية مستحقة الآن. ما أفضل إجراء؟

1. Aحجب الجرعة، وإبلاغ الواصف، وفحص وظائف الكلى
2. Bإعطاء الجرعة في موعدها وإعادة فحص القاع بعد أسبوع
3. Cإعطاء الجرعة خلال وقت أقصر لتقليل التعرض
4. Dإعطاء جرعة مضاعفة لإنهاء الكورس أسرع

Which ECG change is typical of hypokalaemia?

1. AST elevation in leads II, III and aVF
2. BTall, peaked T waves
3. CFlattened T waves and prominent U waves
4. DA very short PR interval with a delta wave

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

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

How is a patient usually positioned for a thoracentesis?

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

A patient with a valid, documented do-not-attempt-CPR decision (DNACPR in the UK, DNR or DNAR in the US) is found in cardiac arrest. What should the nurse do?

1. AStart CPR but use only chest compressions
2. BCall the arrest team and let them decide whether to resuscitate
3. CStart full CPR because the patient's family is not present
4. DNot start CPR, call for support, and provide dignity and comfort

في مريض لديه إصابة حادة في الحبل الشوكي عند C6، أيّ صورة توحي بالصدمة العصبية المنشأ؟

1. Aضغط دم منخفض ونبض بطيء وجلد دافئ جاف
2. Bضغط دم مرتفع ونبض بطيء وصداع نابض
3. Cضغط دم منخفض ونبض سريع وجلد بارد رطب
4. Dضغط دم طبيعي ونبض سريع وحمى شديدة

Six hours after a catheter is removed, a patient has not passed urine and feels uncomfortable. What should the nurse do?

1. ATell the patient to drink two litres of water quickly
2. BDo a bladder scan to check for retention
3. CPut the catheter back without assessing
4. DWait until the next morning before checking

How should a patient use an incentive spirometer after surgery?

1. AUse it once a day, just before going to sleep at night
2. BBreathe in slowly and deeply, then hold briefly
3. CBlow out as hard and as fast as possible
4. DBreathe quickly in and out ten times in a row

While a central line is disconnected, a patient suddenly becomes breathless with chest pain and hypotension. Air embolism is suspected. What should the nurse do first?

1. AClamp the line, lie the patient left side down, head low; give oxygen
2. BGive the patient a drink and observe for an hour
3. CRemove the central line straight away and leave the site open to the air
4. DSit the patient fully upright and flush the line