تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A nurse teaches a patient to use an incentive spirometer. Which statement shows a need for further teaching?

1. A“I will try to hold my breath for a few seconds at the top.”
2. B“I will breathe in slowly and deeply through the mouthpiece.”
3. C“I will use it several times every hour while awake.”
4. D“I will blow into it as hard and fast as I can.”

بعد التسليم والاستلام، أي مريض ينبغي أن تقيّمه الممرضة أولًا؟

1. Aبعد ساعة من قسطرة القلب عبر الفخذ: ألم ظهر جديد، نبض 118/min، ضغط 92/58 mmHg
2. Bمريض COPD على أكسجين 2 L/min: SpO₂ 90%، معدل التنفس 22/min، في حالته الأساسية المعتادة
3. Cسكري النوع 2: غلوكوز 210 mg/dL (11,7 mmol/L) قبل الغداء، دون أعراض
4. Dاليوم الثاني بعد جراحة المرارة: ألم 6/10، المسكن التالي مستحق خلال 30 دقيقة

A patient is on seizure precautions. Which equipment should be ready at the bedside?

1. ARestraints ready for all four limbs
2. BWorking suction and oxygen equipment
3. CA tongue blade to put between the teeth
4. DAn ice pack to place on the forehead

A patient is on contact precautions. Which task is appropriate for the nurse to delegate to assistive personnel?

1. AHelping the patient bathe while wearing a gown and gloves
2. BDeciding when the precautions can be stopped
3. CAssessing the wound for new signs of infection during the bath
4. DTeaching the family how to follow the precautions

A patient is starting dabigatran, a direct oral anticoagulant. Which laboratory test is most important to review before the first dose?

1. ATSH, to rule out an overactive thyroid gland
2. BINR, to set the dose of the anticoagulant
3. CKidney function (creatinine clearance)
4. DLipase, to rule out an inflamed pancreas first

A patient in DKA is receiving IV fluids and insulin. The glucose has fallen to about 220 mg/dL (12,2 mmol/L), but the anion gap is still high. What change would the nurse expect?

1. AStop the IV fluids and start oral fluids only
2. BGive an IV bolus of sodium bicarbonate at once
3. CStop the insulin infusion because the glucose is near normal
4. DAdd dextrose to the IV fluids and continue the insulin

After removing a peripheral IV cannula, what should the nurse check?

1. AThat the site is left uncovered and bleeding freely
2. BThat the cannula is put back in its sterile packet for the next patient
3. CThat the cannula is intact, and apply pressure until bleeding stops
4. DThat the patient's blood glucose is normal before removal

A nurse phones a doctor about a deteriorating patient using SBAR. Which statement belongs in the "R" section?

1. A"I am calling about Mr Smith, who is breathless."
2. B"His blood pressure is 85/50 and he is confused."
3. C"Please review him within the next 15 minutes."
4. D"He was admitted three days ago with pneumonia."

A patient's capillary refill time at the fingertip is 4 seconds. What does this suggest?

1. ANormal peripheral perfusion
2. BA high haemoglobin level
3. CReduced peripheral perfusion
4. DAn unusually strong cardiac output

مريض يتناول الأبيكسابان بسبب الرجفان الأذيني محجوز لجراحة اختيارية. أيّ عبارة تعكس الممارسة الصحيحة؟

1. Aيُوقف ثم يُعكس بفيتامين K فموي
2. Bيُوقف قبل الجراحة بأسبوعين ويُستبدل بالوارفارين
3. Cيُوقف لمدة محددة، بحسب خطر النزف ووظيفة الكلى
4. Dيُستمر عليه دائمًا حتى صباح العملية

After transsphenoidal pituitary surgery, which advice should the patient follow?

1. ADrink through a straw to keep the nose clean
2. BLie completely flat for at least a week after surgery
3. CBlow the nose often to clear any clots
4. DAvoid blowing the nose, straining and bending forward

During a water deprivation test for suspected diabetes insipidus, the patient loses more than 3% of body weight and becomes hypotensive. What should the nurse do?

1. AStop the test and inform the doctor
2. BGive the patient a large drink and then restart the test
3. CGive desmopressin without a prescription
4. DContinue the test, because this result is expected

Which finding suggests a deep tissue pressure injury?

1. AIntact skin that is purple or maroon over a bony area
2. BDry, flaky skin on both shins
3. CPale pink skin that blanches quickly when pressed
4. DA small scratch on the skin with a little fresh red blood

A patient with advanced cancer who has capacity decides to stop chemotherapy. The family insists that treatment must continue. What should the nurse do?

1. AAsk the family to sign a new consent form
2. BSupport the patient's decision and help the team talk with the family
3. CTell the patient that stopping is not allowed
4. DContinue treatment because the family has asked for it