تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

An older adult asks for something to help them sleep. Which drug is most likely to cause confusion and falls in this age group?

1. AAcetaminophen (paracetamol)
2. BA warm milky drink
3. CMelatonin
4. DDiphenhydramine

A competent adult patient refuses a blood transfusion for religious reasons. What should the nurse do?

1. AAsk the family to persuade the patient until they agree
2. BGive the transfusion while the patient is asleep, because saving their life comes first
3. CTell the patient that refusing treatment is not allowed in hospital
4. DRespect the refusal, check the patient understands the risks and inform the provider

How should a nurse handle soiled bed linen?

1. AShake it out first to check for lost items
2. BHold it away from the uniform and place it straight into a linen bag
3. CCarry it bundled against the body to the soiled utility room down the hall
4. DPut it on the floor until the bed is made

A handwritten order is hard to read, and the nurse is not sure of the drug name. What should the nurse do?

1. AChoose the drug that seems most likely from the diagnosis
2. BContact the prescriber to clarify before giving anything
3. CAsk a colleague to guess what it says
4. DHold the drug until the next day without telling anyone

A patient receives repeated nebulized albuterol (salbutamol) for severe asthma. Which laboratory change should the nurse watch for?

1. AA fall in serum potassium
2. BA rise in serum calcium
3. CA fall in blood glucose
4. DA rise in serum sodium

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. BVitamin B₁₂ deficiency
3. CVitamin D (calciferol) deficiency
4. DIron deficiency from gut loss

When a patient returns to the ward from theatre, what should the nurse assess first?

1. AThe patient's dietary preferences for the next meal
2. BThe discharge date
3. CAirway, breathing, circulation and level of consciousness
4. DWhether visitors are waiting to see the patient

An adult with capacity refuses a blood transfusion for religious reasons, even though it may save their life. What should the nurse do?

1. ARespect the refusal, check it is informed and document it, and inform the team
2. BAsk a family member to consent instead
3. CSedate the patient so the transfusion can be given
4. DGive the transfusion while the patient is asleep, as it is in their best interests

A peripheral cannula site is red, warm, tender and swollen along the vein. What should the nurse do?

1. AFlush the cannula hard to clear it
2. BLeave it in place, as this is normal after 24 hours
3. CCover the site and keep using it until it blocks
4. DRemove the cannula, document and monitor the site

A patient with lung cancer develops swelling of the face and arms, distended neck and chest veins and breathlessness that is worse when bending forward. What is the most likely cause?

1. AA deep vein thrombosis in the leg
2. BRight-sided heart failure
3. CAn allergic reaction to chemotherapy
4. DSuperior vena cava obstruction

لماذا يُوزن المريض قبل كل جلسة غسيل دموي وبعدها؟

1. Aلحساب جرعة كل دواء للأسبوع القادم
2. Bلأن الجهاز لا يستطيع البدء دون وزن
3. Cللتحقق من فقد الوزن الناجم عن سوء التغذية
4. Dلمعرفة كمية السوائل التي أُزيلت وتوجيه «الوزن الجاف»

A patient with acute glomerulonephritis has a BP of 190/115 mmHg, a severe headache and blurred vision. Which is the priority?

1. ARecheck the BP at the next routine round
2. BGive extra oral fluids to correct the low urine output
3. CUrgent escalation for BP control and close neuro checks
4. DEncourage a walk to relieve the headache

Which statement about pain relief in acute pancreatitis is correct?

1. APain relief should be withheld until the diagnosis is certain
2. BOpioids must never be used in pancreatitis
3. COnly paracetamol may be given
4. DOpioids can be used, and good analgesia is a priority

An immobile patient on opioids drinks very little. Which laxative choice is least appropriate?

1. AA stimulant laxative taken regularly
2. BA stool softener with a stimulant laxative
3. CAn osmotic laxative such as a macrogol
4. DA bulk-forming laxative used on its own