تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

يسأل مريض مساعد التمريض عن الآثار الجانبية لدواء جديد. ماذا ينبغي أن يفعل المساعد؟

1. Aالبحث عن الدواء على الإنترنت وقراءة ما يقوله
2. Bشرح الآثار الجانبية المذكورة في نشرة الدواء للمريض
3. Cطمأنة المريض بأن الآثار الجانبية نادرة
4. Dالقول إن الممرضة ستأتي للإجابة، وإبلاغ الممرضة

A patient admitted with a stroke this morning asks for a glass of water. What should the nurse do first?

1. AGive thickened fluids without checking the swallow
2. BGive the water through a straw so it goes down slowly
3. CAsk the family to help the patient drink while sitting upright in a chair at the bedside
4. DCheck that a swallow screen has been done before giving anything by mouth

A cup of water is spilled over an infusion pump plugged into the wall. What should the nurse do?

1. ASwitch it off and unplug it safely, then have it checked before reuse
2. BWipe it dry quickly with a towel and keep using it for the infusion
3. CTurn the pump upside down to drain it while running
4. DLeave it running and place a towel over it until it dries

The fire alarm sounds, but the nurse does not know where the fire is. What should the nurse do?

1. AClose the doors to patient rooms, stay on the unit and wait for instructions
2. BOpen all doors so patients can be seen easily
3. CEvacuate all patients down the stairs at once, starting with those in bed
4. DLeave the unit and the building to find out where the fire is

During a red cell transfusion, when are serious acute reactions most likely, so the nurse stays with the patient?

1. AIn the first 15 minutes
2. BAfter the last drop is given
3. CThe next morning
4. DAfter about 2 hours

During surgery under general anesthesia, a patient develops a rising end-tidal CO₂, muscle rigidity and tachycardia, then a high potassium and a rising temperature. Which condition is most likely?

1. AAcute hemolytic transfusion reaction
2. BHypovolemic shock
3. CMalignant hyperthermia
4. DHypoglycemia from fasting

Why does a patient with a suspected TIA need urgent specialist assessment?

1. AA TIA always turns into a brain tumour unless it is treated
2. BThe patient needs urgent surgery on the brain
3. CThe risk of a full stroke is highest in the days after a TIA
4. DThe symptoms will come back permanently within an hour

Why might a patient with diabetes who takes a beta-blocker not notice hypoglycaemia early?

1. ABeta-blockers make the patient sleep through the night
2. BBeta-blockers can mask warning signs such as tremor and a fast heart rate
3. CBeta-blockers stop the liver from responding to insulin
4. DBeta-blockers raise blood glucose, so true hypoglycaemia cannot happen at all

A patient has pneumonia in the right lung only. In which side-lying position will oxygenation usually be best?

1. ALying on the right side, with the affected lung down
2. BProne with the head down
3. CLying on the left side, with the healthy lung down
4. DFlat on the back with no pillows

After positive end-expiratory pressure (PEEP) is increased on a ventilated patient, the blood pressure falls. What is the most likely reason?

1. AHigher chest pressure reduces venous return to the heart
2. BPEEP causes immediate blood loss from the alveolar capillaries
3. CPEEP directly weakens the heart muscle and its contraction
4. DPEEP lowers the blood oxygen level

A patient on peritoneal dialysis has gained weight and has higher glucose levels. Which part of the treatment is the likely cause?

1. ASodium lost into the dialysis fluid
2. BGlucose absorbed from the dialysis fluid
3. CProtein lost into the dialysis fluid
4. DAir entering the abdomen during exchanges

مريض موصول بجهاز تنفس صناعي مصاب برضح دماغي. أيّ هدف لـ PaCO₂ يُسعى إليه عادةً ما لم يكن الفتق وشيكًا؟

1. APaCO₂ منخفض بفرط تهوية مطوّل
2. Bأي PaCO₂ لأنه لا يؤثر في الضغط داخل القحف
3. CPaCO₂ مرتفع لفتح الأوعية الدماغية
4. DPaCO₂ طبيعي (طبيعي ثنائي أكسيد الكربون)

What does "neoadjuvant" treatment mean?

1. ATreatment that is given instead of any surgery
2. BTreatment given only for pain relief
3. CTreatment before the main treatment, often to shrink the tumour
4. DTreatment that is given only after the cancer has already spread

After forearm fracture surgery, a patient has severe pain not eased by opioids, made worse by passively moving the fingers. What should the nurse do?

1. ARaise the arm as high as possible and give a further dose of opioid
2. BReassure the patient that this pain is expected
3. CLoosen any tight dressing, keep the arm at heart level and escalate
4. DApply ice and a tighter bandage to reduce the swelling