تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A patient with type 1 diabetes has vomited since morning and cannot eat. Which action is most important?

1. ACheck the blood glucose and ketones and contact the provider
2. BStop all insulin until the patient is able to eat normally again
3. CWait until tomorrow to see if the vomiting settles
4. DEncourage a large meal to settle the stomach

A patient was knocked out briefly in a fall, then woke and talked normally. Two hours later the patient becomes drowsy and one pupil is larger. What is the most likely cause?

1. AAn epidural hematoma
2. BA mild concussion that is settling
3. CLow blood sugar from missing a meal
4. DNormal tiredness after a fall

Before inserting a peripheral IV, the nurse cleans the skin with chlorhexidine-alcohol. What should the nurse do next?

1. ALet it dry fully and do not touch the site again
2. BWipe it off with a dry gauze straight away
3. CBlow on the site so it dries faster
4. DFeel for the vein again with an ungloved finger

أدركت ممرضة تعتني بمريض مطبَّقة عليه احتياطات التلامس أن في كمّ الثوب تمزقًا. ماذا ينبغي أن تفعل؟

1. Aمواصلة العمل، لأن التمزق صغير وفي الكمّ فقط
2. Bالابتعاد عن المريض، وخلع معدات الوقاية بأمان عند الباب، وتنظيف اليدين وارتداء ثوب جديد
3. Cتغطية التمزق بشريط لاصق والمتابعة
4. Dارتداء ثوب ثانٍ فوق الممزق

A patient is on an IV insulin infusion protocol in the ICU. How often is the blood glucose usually checked?

1. AOnce every 12 hours
2. BAbout every hour
3. COnce a day before breakfast
4. DOnly if symptoms occur

A patient with a round face, central weight gain and purple stretch marks has a glucose of 210 mg/dL (11,7 mmol/L) and a potassium of 3,1 mEq/L. Which condition fits best?

1. AAdrenal insufficiency
2. BCushing syndrome
3. CDiabetes insipidus
4. DHypothyroidism

يُظهر مخطط توازن السوائل لمريض مدخولًا قدره 1,200 mL وإخراجًا قدره 2,300 mL خلال 24 ساعة. على ماذا يدل ذلك؟

1. Aتوازن سوائل إيجابي قدره 3,500 mL
2. Bتوازن سوائل سلبي قدره 1,100 mL
3. Cتوازن سوائل إيجابي قدره 1,100 mL
4. Dحالة سوائل متوازنة

An older patient has fallen several times since starting a new medicine. Which drug group is most likely to contribute?

1. AEmollient creams applied to the legs
2. BBenzodiazepine sleeping tablets
3. CVitamin D supplements
4. DLubricating eye drops

Which ECG finding is typical of atrial flutter?

1. AA chaotic baseline with no clear P waves and irregular QRS
2. BRegular sawtooth flutter waves between QRS complexes
3. CWide, bizarre QRS complexes at 180/min
4. DP waves with no relationship to the QRS complexes

A patient who has had a total laryngectomy becomes breathless and needs oxygen. How should it be given?

1. AVia nasal cannula at 2 L/min
2. BVia a mask or humidified device over the neck stoma
3. CVia a standard face mask over the nose and mouth
4. DVia a non-rebreather mask over the mouth only

After a lumbar discectomy, which finding should the nurse report promptly?

1. ANew weakness or numbness in the legs
2. BStiffness when getting out of bed
3. CMild pain at the wound site
4. DA dry, intact wound dressing

A patient with stable epilepsy on phenytoin started a new medicine last week. They now have nystagmus, an unsteady gait and slurred speech. What should the nurse do?

1. AGive the next phenytoin dose early to prevent a seizure
2. BSuspect phenytoin toxicity, hold the next dose and ask for a drug level
3. CSuspect a new stroke and give aspirin straight away before any scan
4. DEncourage the patient to walk more to improve their balance

How can low-dose opioids help a patient with breathlessness from advanced cancer?

1. AThey reduce the feeling of breathlessness
2. BThey open the airways like an inhaler
3. CThey increase the oxygen level in the blood
4. DThey cure the underlying lung disease

في اليوم الثالث بعد جراحة الورك، يصاب مسنّ بتشوش حاد مع تذبذب الانتباه وهياج. ماذا ينبغي أن تفعل الممرضة أولًا؟

1. Aافتراض أنه خرف ومواصلة خطة الرعاية دون تغيير
2. Bأن تطلب من الأسرة أخذ المريض إلى المنزل ليهدأ
3. Cتقييد المريض وإعطاؤه جرعة كبيرة من مهدئ فورًا
4. Dالبحث عن أسباب مثل نقص الأكسجة أو العدوى أو الألم أو الأدوية، والتصعيد