تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A patient wants to leave the hospital against medical advice. What should the nurse do?

1. AInform the provider, explain the risks and document the discussion
2. BLet the patient leave without telling anyone
3. CLock the door so the patient cannot leave the unit
4. DHide the patient’s clothes and belongings until the provider arrives

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. ANormal tiredness after a fall
2. BAn epidural hematoma
3. CA mild concussion that is settling
4. DLow blood sugar from missing a meal

أيّ ممارسة مع قوارير الأدوية والمحاقن آمنة؟

1. Aاستخدام إبرة ومحقنة معقمتين جديدتين في كل مرة تُثقب فيها القارورة
2. Bإعادة استخدام محقنة إذا رُكّبت عليها إبرة جديدة
3. Cاستخدام المحقنة نفسها لمريضين إذا شُطفت
4. Dترك إبرة في سدادة القارورة لاستخدامها لاحقًا

أيّ نهج يمنع على أفضل وجه عدوى المسالك البولية المرتبطة بالقسطرة عندما تكون القسطرة البولية لازمة بوضوح؟

1. Aإبقاء الكيس على السرير، بمستوى المثانة
2. Bفصل الكيس بانتظام لإفراغه بسهولة أكبر
3. Cتغيير القسطرة يوميًا لإبقائها نظيفة وخالية من القشور
4. Dإدخال بتقنية معقمة، ونظام مغلق، ومراجعة يومية للحاجة

A healthy patient has a mildly raised CK after running a marathon yesterday, without dark urine or symptoms. What is the most likely explanation?

1. AStrenuous exercise raised CK from skeletal muscle
2. BAn acute myocardial infarction has occurred
3. CThe patient has developed acute pancreatitis
4. DThe patient has developed acute hepatitis

A patient has taken metformin for 8 years and now has numbness in the feet, a hemoglobin of 10,2 g/dL (102 g/L) and an MCV of 108 fL. Which deficiency is most likely?

1. AVitamin K deficiency
2. BIron deficiency from gut loss
3. CVitamin B₁₂ deficiency
4. DVitamin D (calciferol) deficiency

After removing a peripheral IV cannula, what should the nurse check?

1. AThat the cannula is put back in its sterile packet for the next patient
2. BThat the cannula is intact, and apply pressure until bleeding stops
3. CThat the site is left uncovered and bleeding freely
4. DThat the patient's blood glucose is normal before removal

A patient with a central venous catheter needs the line removed. Which position reduces the risk of air embolism during removal of a neck or chest line?

1. ASitting fully upright and taking a deep breath in as the line comes out
2. BStanding up and walking
3. CLying on the right side with the legs raised
4. DLying flat or slightly head-down, holding the breath or breathing out

A patient with COPD uses an inhaled corticosteroid combination inhaler. Which risk should the nurse be aware of?

1. AHearing loss after every dose
2. BAn increased risk of pneumonia
3. CAn increased risk of high blood pressure crises
4. DA sharp drop in potassium after each dose

After chest trauma, a patient is hypotensive with reduced breath sounds on the left. Which finding suggests a haemothorax rather than a tension pneumothorax?

1. ATrachea pushed away from the affected side
2. BDullness to percussion on the affected side
3. CHyper-resonance on the affected side
4. DDistended neck veins

استمرت نوبة صرع خمس دقائق ولا تزال مستمرة. ما العلاج الدوائي الأول المعتاد؟

1. Aغلوكوز 50% وريديًا لكل مريض، ثم إعادة التقييم
2. Bأدرينالين عضلي في الفخذ الخارجي
3. Cبنزوديازيبين مثل اللورازيبام وريديًا أو الميدازولام الشدقي
4. Dجرعة تحميل وريدية من الفينيتوئين قبل أي شيء آخر

A patient with an acute stroke has a glucose of 15 mmol/L (270 mg/dL). They do not have known diabetes. What is appropriate?

1. AStop all IV fluids to lower the glucose
2. BReport it and monitor glucose, as it can worsen outcome
3. CIgnore it, because stress always raises glucose
4. DGive glucose gel to stabilise the level

Which burn should usually be discussed with a specialist burns service even if it is small?

1. AA partial-thickness burn on the hand
2. BA healed burn scar from many years ago
3. CA tiny burn on the forearm with redness only
4. DA small superficial sunburn on the back

Two days after a PEG insertion, a patient reports pain on feeding, and feed is leaking around the site. What should the nurse do?

1. AStop the feed at once and seek urgent medical advice
2. BIncrease the feed rate to improve nutrition
3. CContinue feeding and apply a thicker dressing
4. DGive the next medicines through the tube as usual