تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A malnourished patient admitted with alcohol use disorder needs IV glucose. Which vitamin is given before or with it?

1. AVitamin C (ascorbic acid)
2. BVitamin K (phytonadione)
3. CVitamin D (calciferol)
4. DThiamine (vitamin B₁)

خروج أي مريض مخطط له ينبغي أن تستوضحه الممرضة؟

1. Aمريض بعد إصلاح فتق يتبول ويأكل
2. Bمريض ذات رئة بلا حمّى منذ 48 ساعة على مضادات حيوية فموية
3. Cمريض بعد يومين من الجراحة معدل نبضه الجديد 112/min وحرارته 38,4 °C
4. Dمريض بجبيرة مستقرة يمشي بأمان بالعكازين

A patient wants to use their own electric hair dryer in the hospital. What is correct?

1. AIt can be plugged into an extension lead under the bed
2. BIt can be used in the bathroom near the sink if the patient is careful
3. CIt can be used straight away if it looks new
4. DIt is checked for electrical safety according to hospital policy before use

تهمّ ممرضة بإعطاء مورفين وريدي. معدل تنفس المريض 9/دقيقة وهو شديد النعاس. ماذا ينبغي أن تفعل؟

1. Aإعطاء الجرعة لأن الألم أُبلغ عنه سابقًا
2. Bإعطاء الجرعة وإعادة فحص معدل التنفس غدًا
3. Cحجب الجرعة وتقييم المريض وإبلاغ واصف الدواء
4. Dإعطاء نصف الجرعة

A patient with hyponatremia from SIADH starts tolvaptan. Why is the serum sodium checked frequently in the first day?

1. AThe sodium always falls further
2. BThe drug causes severe hyperkalemia
3. CThe sodium can rise too quickly
4. DThe drug lowers blood glucose sharply

A patient on long-term amiodarone has fatigue and weight gain. TSH is 11 mIU/L and the free T₄ is low. What is the most likely explanation?

1. AAmiodarone-induced hypothyroidism
2. BSecondary hypothyroidism from pituitary failure
3. CA normal response to amiodarone needing no action
4. DAmiodarone-induced hyperthyroidism

Which blood result often rises in an upper GI bleed because blood is digested in the gut?

1. ASodium
2. BCalcium
3. CUrea (blood urea nitrogen)
4. DGlucose

A nurse teaches a patient with hypertension about their medicines. Which statement shows a need for further teaching?

1. A"I'll get up slowly from sitting."
2. B"I'll keep taking my tablets even if I feel well."
3. C"I'll stop my tablets once my readings are normal."
4. D"I'll have my blood pressure checked regularly."

How do clopidogrel and ticagrelor work?

1. AThey inhibit the vitamin K-dependent clotting factors in the liver
2. BThey dissolve fibrin in existing clots
3. CThey directly inhibit thrombin in the plasma
4. DThey block the platelet ADP (P2Y₁₂) receptor

A patient on a morphine PCA after surgery is very drowsy, with a respiratory rate of 7/min and pinpoint pupils. SpO₂ is 89%. What should the nurse do first?

1. AGive a sedative to keep the patient comfortable
2. BEncourage the patient to keep pressing the PCA button for comfort
3. CLeave the patient to sleep and recheck the observations in an hour
4. DStop the PCA, support breathing, give oxygen and get naloxone

Why is IV calcium gluconate given in severe hyperkalaemia?

1. AIt binds potassium in the gut
2. BIt protects the heart from arrhythmias
3. CIt removes potassium through the kidneys
4. DIt moves potassium into the cells

Why may nitrofurantoin be avoided in an older patient with significantly reduced kidney function?

1. AIt works less well and is more likely to be toxic
2. BIt turns the urine red in kidney disease
3. CIt cures kidney disease too quickly
4. DIt cannot be taken with food in kidney disease

ما الفرق السريري الرئيسي بين انسداد الأمعاء الدقيقة والغليظة؟

1. Aالدقيقة: لا تقيؤ إطلاقًا؛ الغليظة: تقيؤ غزير مبكر بلا تمدد
2. Bالدقيقة: تقيؤ مبكر وتمدد أقل؛ الغليظة: تقيؤ متأخر وتمدد واضح
3. Cلا فرق سريري؛ فقط التصوير المقطعي يميز بينهما
4. Dالدقيقة: تمدد واضح فقط؛ الغليظة: لا ألم ولا تقيؤ ولا تمدد إطلاقًا

A patient with diabetes has rapidly spreading redness around a small wound, severe pain out of proportion, fever and crackling under the skin. What should the nurse suspect?

1. AMild contact dermatitis
2. BA simple insect bite
3. CA healing venous ulcer
4. DNecrotising fasciitis