تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

When making patient assignments, what should the charge nurse consider first?

1. ALetting staff choose the patients they prefer
2. BMatching each patient’s needs to staff competence
3. CGiving the newest staff the most complex patients
4. DGiving each nurse patients in rooms next to each other

Which patient finding after a total knee replacement needs the nurse’s action first?

1. ASudden calf pain and swelling in the operated leg, with new breathlessness
2. BPain of 4/10 when the physiotherapist bends the knee during the morning session
3. CAsks for an ice pack to help with swelling around the knee
4. DA small amount of dried blood on the dressing

أثناء فاشية للنوروفيروس في قسم، ما طريقة نظافة اليدين التي ينبغي أن يستخدمها العاملون بعد رعاية المريض؟

1. Aالغسل بالماء والصابون
2. Bلا حاجة إلى نظافة اليدين إذا استُخدمت القفازات
3. Cمسح اليدين بمنشفة ورقية فقط
4. Dالمطهّر الكحولي لليدين فقط

A nurse teaches a patient who has had a splenectomy. Which statement shows a need for further teaching?

1. A“I will keep my vaccinations up to date.”
2. B“Now that my spleen is out, a fever is nothing to worry about.”
3. C“I will get medical help quickly if I get a high temperature.”
4. D“I will tell all of my health care providers that I have no spleen.”

A patient has a hot, swollen big toe. The serum uric acid is normal. Which statement is correct?

1. AGout can only be diagnosed with a CT scan of the foot
2. BGout is certain, as a normal urate proves the diagnosis
3. CGout is ruled out, as uric acid is always high in an attack
4. DGout is still possible, as urate can be normal in an attack

A child with sickle cell disease and a recent viral illness is pale and tired. The hemoglobin has fallen sharply, and the reticulocyte count is very low. What is the most likely problem?

1. AAn aplastic crisis, often caused by parvovirus B19
2. BA vaso-occlusive pain crisis in the bones
3. CA normal finding in sickle cell disease
4. DIron deficiency from a poor diet over months

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

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

Why is a large pleural effusion drained slowly rather than all at once?

1. AQuick drainage causes the effusion to spread to the other lung
2. BRapid drainage can cause re-expansion pulmonary oedema
3. CSlow drainage stops the patient needing oxygen
4. DFluid drained quickly turns into blood

A peripheral cannula site is red, warm, tender and swollen along the vein. What should the nurse do?

1. ALeave it in place, as this is normal after 24 hours
2. BCover the site and keep using it until it blocks
3. CRemove the cannula, document and monitor the site
4. DFlush the cannula hard to clear it

The stump of a recent below-knee amputation suddenly bleeds heavily through the dressing. What should the nurse do first?

1. ARemove all the dressings and wait for the bleeding to stop by itself
2. BEncourage the patient to walk on crutches to ease the pressure
3. CApply a warm compress to the stump
4. DApply firm direct pressure and call for urgent surgical help

A patient with severe vomiting and diarrhoea takes ramipril, furosemide and metformin. Which advice is correct?

1. ADouble the furosemide to prevent fluid retention
2. BAdd ibuprofen to treat the abdominal cramps
3. CKeep taking everything as normal and drink less
4. DPause these medicines until eating and drinking again

أيّ من هؤلاء المرضى المصابين بسكتة إقفارية حادة هو الأقل احتمالًا ليكون مؤهلًا لحلّ الخثرة الوريدي؟

1. Aمريض أجرى جراحة بطنية كبرى قبل خمسة أيام
2. Bمريض ضغط دمه 170/95 mmHg
3. Cمريض بدأت أعراضه قبل 90 دقيقة
4. Dمريض لا يُظهر تصويره المقطعي أي علامة لنزف داخل القحف

Which drug class is used to reduce the risk of a first variceal bleed in cirrhosis?

1. AThiazide diuretics
2. BNon-selective beta-blockers
3. CProton pump inhibitors
4. DCalcium supplements

انسكبت كمية صغيرة من دواء سام للخلايا على الأرض من ممرضة. ما النهج الصحيح؟

1. Aتركه يتبخر وإبعاد الناس بضع دقائق
2. Bمسحه بمنديل ورقي ووضعه في سلة النفايات العامة
3. Cاستخدام عدة الانسكاب مع معدات الوقاية، والتنظيف، والوضع في كيس كنفايات سامة للخلايا، والإبلاغ
4. Dمسحه بممسحة القسم وشطف الممسحة في المغسلة