تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A child with fever and headache develops a purple rash that does not fade when pressed with a glass. What should the nurse do?

1. AAdvise the family to see their doctor next week
2. BGive acetaminophen (paracetamol) and reassess in four hours
3. CTreat it as an emergency and escalate at once
4. DApply a soothing cream to the rash

A patient with a head injury has a pupil on one side that is now large and does not react to light. What should the nurse do?

1. ADim the room lights so the pupil can get smaller
2. BReport it at once, as it may mean the brain is being compressed
3. CRecheck it at the next routine observation in four hours
4. DDocument it, because pupils often differ slightly after a head injury

A patient has fallen, and the nurse completes an incident report. Which statement about this report is correct?

1. AIt replaces the need to document the fall in the patient’s record
2. BIt is written factually and does not replace documenting the fall in the patient’s record
3. CIt is only needed when the patient is injured
4. DA copy of it is placed in the patient’s chart so all staff know about the fall

A nurse who is not immune to chickenpox was exposed to a patient with varicella before precautions began. What usually happens?

1. AThe nurse is assessed and kept from patient contact during the incubation period per policy
2. BThe nurse continues working with all patients as usual, including newborns
3. CThe nurse only needs to wear gloves for the next month
4. DThe nurse must take a two-week course of antibiotics to prevent the infection

مريض يتناول الفينيتوين مستواه 28 mcg/mL (المدى المعتاد نحو 10–20 mcg/mL). ما العلامات التي تتوقعها الممرضة؟

1. Aموجات T عالية مدببة
2. Bجوع وزيادة وزن
3. Cسلوك مفرط النشاط وأرق فقط
4. Dرأرأة (nystagmus) ومشية غير ثابتة وكلام متداخل

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

A patient's low potassium does not improve despite potassium replacement. Which other electrolyte should be checked?

1. ASodium
2. BChloride
3. CPhosphate
4. DMagnesium

A patient with full mental capacity decides against a treatment that the team thinks is best. What does the Mental Capacity Act 2005 (England and Wales) say?

1. AA person is not treated as lacking capacity just because they make an unwise decision
2. BThe patient must be assessed by a psychiatrist before refusing
3. CThe family may make the decision instead if they disagree with the patient's choice
4. DThe team may override any decision that it disagrees with if it is serious

What is the main problem in heart failure with preserved ejection fraction?

1. AA dilated ventricle that cannot contract strongly
2. BA stiff ventricle that fills poorly in diastole
3. CA leaking aortic valve
4. DA blocked pulmonary artery

تخطط ممرضة لرعاية أربعة مرضى. أيّ مريض ينبغي تقييمه أولًا؟

1. Aمريض بقرحة وريدية حان موعد تغيير ضمادها
2. Bمريض COPD انخفض SpO₂ لديه من 90% إلى 83% مع نعاس جديد
3. Cمريض بارتفاع ضغط مضبوط يسأل عن الملح
4. Dمريض قصور قلب مستقر ينتظر وزنه اليومي

After a change in the levothyroxine dose, when is the TSH usually rechecked?

1. AAfter about 2 years of treatment
2. BAfter 3 days
3. CAfter about 6–8 weeks
4. DAfter 24 hours

يبدأ مريض مصاب بالسكري الكاذب المركزي الديسموبريسين. أيّ مضاعفة ينبغي أن تراقبها الممرضة؟

1. Aفرط بوتاسيوم الدم
2. Bفرط سكر الدم
3. Cنقص صوديوم الدم
4. Dإسهال شديد

أيّ تقييمات عند السرير تُستخدم لمتابعة الاستسقاء؟

1. Aحجم الحدقة واستجابتها مرتين يوميًا
2. Bذروة التدفق وتشبع الأكسجين
3. Cسكر الدم الشعري قبل كل وجبة
4. Dالوزن اليومي ومحيط البطن

مريض لديه دوالي مريء معروفة يتقيأ كميات كبيرة من الدم الطازج. ما العلاجات التي ينبغي أن تتوقعها الممرضة قبل التنظير؟

1. Aمضاد التهاب غير ستيرويدي فموي للألم ووجبة غنية بالبروتين
2. Bتسريب سريع للمحلول الملحي حتى ضغط دم مرتفع
3. Cبلعة باريوم عاجلة قبل أي علاج دوائي
4. Dالأوكتريوتيد أو التيرليبريسين، مع مضادات حيوية وريدية، أثناء الإنعاش