تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A patient taking lithium has vomiting, diarrhea and a new coarse tremor. What should the nurse do?

1. AEncourage the patient to cut down on salt and fluids
2. BHold the next dose and report for an urgent lithium level
3. CGive the dose with food to reduce the stomach upset
4. DReassure the patient that a coarse tremor is expected at first

A patient has a potassium of 7,0 mEq/L with peaked T waves. Several drugs are prescribed. Which one is usually given first to protect the heart?

1. AOral potassium binder
2. BIV calcium gluconate
3. COral sodium bicarbonate
4. DIV furosemide

A patient with difficulty swallowing is prescribed an extended-release tablet. What should the nurse do?

1. ADissolve the tablet in a glass of hot water
2. BAsk the prescriber or pharmacist for another form and not crush the tablet
3. CCut the tablet in half so it is easier to swallow
4. DCrush the tablet finely and mix it into a spoonful of applesauce or yogurt

Which patient should the nurse assess first?

1. AA patient on chemotherapy with a new temperature of 38,4 °C (101,1 °F)
2. BA patient who wants more alcohol hand rub in the room
3. CA patient with tuberculosis who is asking to have visitors
4. DA patient with an MRSA wound due for a routine dressing change

In the third trimester of pregnancy, a woman's alkaline phosphatase (ALP) is about twice the usual adult range, and the other liver tests are normal. What is the best interpretation?

1. AA sign of blocked bile ducts
2. BA sign of acute viral hepatitis
3. CA sign of new bone cancer
4. DA normal rise from placental ALP

A patient with right upper abdominal pain from gallstones now has jaundice, a total bilirubin of 4,8 mg/dL (82 µmol/L) and a raised ALP. What is the most likely cause?

1. AA stone blocking the common bile duct
2. BUncomplicated gallbladder inflammation
3. CGilbert syndrome triggered by pain
4. DHemolysis caused by the gallstones

Which factor is most likely to slow wound healing?

1. AA diet rich in protein
2. BAdequate fluid intake
3. CSmoking
4. DGood blood glucose control

Which feature best distinguishes delirium from dementia?

1. ADelirium only affects people under 50, while dementia affects older people
2. BDelirium is permanent, while dementia is reversible
3. CDelirium starts suddenly and fluctuates, while dementia develops gradually
4. DDementia always causes visual hallucinations

يُظهر المراقب رجفانًا بطينيًا. المريض غير مستجيب ولا يتنفس بشكل طبيعي. ما العلاج الأساسي؟

1. Aأدينوزين وريدي سريع تليه شطفة
2. Bالإنعاش القلبي الرئوي وإزالة الرجفان بأسرع وقت ممكن
3. Cأتروبين وريدي وتنظيم نظم خارجي
4. Dتقويم نظم القلب المتزامن تحت تهدئة عميقة

A woman starting rifampicin (rifampin) for tuberculosis uses a combined oral contraceptive pill. What advice is correct?

1. AStop all contraception during TB treatment, as pregnancy cannot occur
2. BTake two pills a day to make up for the drug
3. CContinue the pill as usual, because there is no interaction with TB drugs
4. DUse another reliable method, as rifampicin reduces the pill's effect

Which group of drugs is a well-known cause of SIADH and hyponatraemia, especially in older people?

1. ABulk-forming laxatives
2. BSSRI antidepressants
3. CPenicillin antibiotics
4. DProton pump inhibitors

On day 6 after a subarachnoid haemorrhage, a patient becomes newly confused and develops weakness in one arm. The aneurysm was secured on day 1. What is the most likely cause?

1. AHypoglycaemia from reduced eating
2. BRe-bleeding from the secured aneurysm
3. CDelayed cerebral ischaemia from vasospasm
4. DNormal tiredness after major surgery

How is an uncomplicated sigmoid volvulus often first treated?

1. AA barium meal given by mouth to untwist the bowel slowly
2. BHigh-dose laxatives taken by mouth
3. CDecompression with a flexible sigmoidoscope and flatus tube
4. DEating a large high-fibre meal

A patient with recurrent diverticulitis reports passing air and faecal matter in the urine. What is the most likely cause?

1. ABowel preparation that was taken too quickly
2. BA fistula between the colon and the bladder
3. CA kidney stone blocking the ureter
4. DA simple lower urinary tract infection