تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

ترى ممرضة مساعد تمريض يقيس ضغط الدم بكُمّة صغيرة جدًا بوضوح. ماذا ينبغي أن تفعل الممرضة؟

1. Aالتدخل الآن وتصحيح التقنية بلباقة وإعادة القياس
2. Bإبعاد المساعد عن رعاية المرضى لبقية اليوم
3. Cذكر الأمر لاحقًا في التقييم السنوي القادم للمساعد
4. Dتجاهله لأن قراءة مرتفعة واحدة لن تهم

A patient with septic shock remains hypotensive, with a mean arterial pressure of 58 mmHg, after adequate IV fluids. What should the nurse anticipate?

1. AAn oral fluid challenge with a sports drink
2. BA beta-blocker to slow the heart rate
3. CA loop diuretic to remove the extra fluid that has been given
4. DA vasopressor, such as norepinephrine, to raise the pressure

A patient needs to be moved up in bed and cannot help much. Which approach is safest?

1. ARaise the head of the bed fully and lift the patient up by the shoulders
2. BUse a friction-reducing sheet with enough staff, with the bed flat if tolerated
3. CHave one nurse pull the patient up by the arms
4. DAsk the patient to push up with their heels alone

During flu season, a nurse wakes up with fever, cough and muscle aches. What is the best action?

1. AGo to work but wear a surgical mask for the whole shift
2. BGo to work but avoid caring for patients who have weak immune systems
3. CTake an antipyretic so the fever does not show at work
4. DStay home and inform the employer according to the illness policy

A patient with sepsis has a lactate of 2,1 mmol/L on admission and 4,3 mmol/L two hours later, despite IV fluids. What does this suggest?

1. AExpected muscle activity from shivering in fever
2. BImproving circulation as the fluids start to work
3. CWorsening tissue perfusion that needs urgent reporting
4. DA normal response to IV fluids in the first hours

نتيجة أي مريض ينبغي أن تبلغ عنها الممرضة أولًا؟

1. Aغلوكوز 42 mg/dL (2,3 mmol/L) لدى مريض يتعرق ومشوش
2. BHbA1c 7,4% (57 mmol/mol) لدى مريض بالسكري من النمط 2
3. Cكرياتينين 1,6 mg/dL (141 µmol/L) لدى مريض بمرض كلوي مزمن مستقر معروف
4. Dكوليسترول كلي أعلى من الهدف بقليل

A patient with DKA has an arterial blood gas showing a low pH and a low bicarbonate. Which disturbance is this?

1. ARespiratory alkalosis
2. BMetabolic alkalosis
3. CMetabolic acidosis
4. DRespiratory acidosis

A nurse teaches a patient with asthma about a new inhaled steroid "preventer". Which statement shows a need for further teaching?

1. A"I'll keep my reliever inhaler with me."
2. B"I will use it every day even when I feel well."
3. C"I will rinse my mouth after using it."
4. D"I will only use it when I'm wheezy."

Why should a long-acting beta-2 agonist (LABA) never be used alone in asthma?

1. AIt cannot be inhaled without a nebuliser
2. BWithout an inhaled steroid, it is linked with severe and fatal attacks
3. CIt works only when it is taken together with a course of antibiotics
4. DIt always causes immediate severe bronchospasm when used on its own

A patient on three blood pressure drugs still has high readings at every visit. What should the nurse check first?

1. AWhether the patient is taking the medicines as prescribed
2. BWhether the readings should be ignored
3. CWhether the patient needs surgery on the renal arteries
4. DWhether a fourth drug can be added at today's appointment

A patient has just started levetiracetam. Which side effect should the nurse teach them to report?

1. AChanges in mood, such as irritability, low mood or anger
2. BSwelling and overgrowth of the gums around the teeth
3. CA persistent dry cough at night
4. DOrange discoloration of the urine

A nurse teaches a young adult with newly diagnosed epilepsy. Which statement shows a need for further teaching?

1. A"I will keep a record of any seizures I have."
2. B"As long as I take my tablets, I can swim alone."
3. C"I will take a shower rather than a bath."
4. D"I will tell my friends what to do if I have a seizure."

Why are antibody levels checked after a healthcare worker receives the hepatitis B vaccine?

1. ATo confirm that the vaccine produced immunity
2. BTo measure liver damage caused by the vaccine
3. CTo check whether they caught hepatitis B from the vaccine
4. DTo decide whether they need a liver biopsy

مريض على PCA أفيوني يتلقى الأكسجين بقناع. SpO₂ 97% ومعدل التنفس 11/min، لكن يصعب إيقاظه الآن. ماذا ينبغي أن تستنتج الممرضة؟

1. Aالمريض آمن لأن تشبع الأكسجين طبيعي
2. Bينبغي زيادة جرعة PCA للحفاظ على راحة المريض
3. Cسمّية الأفيونيات مرجَّحة؛ وقد يحجب الأكسجين نقص التهوية
4. Dالمريض ينام جيدًا ببساطة لأن الألم مضبوط