تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A patient is raising his voice, pacing and clenching his fists. What should the nurse do first?

1. ASpeak calmly, keep a safe distance and invite him to talk about what is wrong
2. BTurn away and ignore the behavior
3. CStand very close to him and tell him firmly and loudly to sit down and be quiet
4. DApply physical restraints at once

An adult has burns over 40% of the body with no signs of airway injury. Which treatment is the priority during the first hours?

1. AGiving a high-protein meal to support healing
2. BApplying antibiotic cream to all the burns before anything else
3. CLarge-volume IV fluids with close monitoring of urine output
4. DStarting physiotherapy to prevent contractures straight away

A nurse finds an unlabeled syringe of clear fluid on the medication counter. What should the nurse do?

1. AGive it to the patient whose medication is due
2. BDiscard it, because its contents cannot be confirmed
3. CLabel it with the most likely drug name
4. DAsk nearby staff and use it if someone recognizes it

In a US hospital (CMS rules), a patient keeps pulling at an endotracheal tube, and alternatives have failed. The nurse applies wrist restraints in an emergency. What must happen next?

1. AAsk the family to sign a consent form instead of an order
2. BAsk the provider for a PRN restraint order to use as needed
3. CObtain a time-limited order for the restraint promptly, following policy
4. DKeep the restraints on without an order until the patient is calm

In the US, when is a pregnant woman without known risk factors usually screened for gestational diabetes?

1. AAt about 38–40 weeks of pregnancy
2. BAt about 24–28 weeks of pregnancy
3. CAt about 6–8 weeks of pregnancy
4. DOnly after the baby is born

A patient with severe hypertriglyceridemia has a measured sodium of 128 mEq/L, but a measured serum osmolality is normal, and the patient has no symptoms. What is the most likely explanation?

1. ATrue hyponatremia from SIADH that needs fluid restriction
2. BPseudohyponatremia, an artifact caused by very high lipids
3. CHyponatremia caused by severe hyperglycemia in diabetes
4. DHyponatremia caused by drinking far too much water

ارتفعت نتيجة NEWS2 لمريض إلى 7. ما الاستجابة المناسبة؟

1. Aتسجيل النتيجة وزيادة المراقبة وانتظار جولة الجناح الصباحية
2. Bإعطاء مهدئ وإعادة القياس لاحقًا
3. Cالاستمرار في قياس العلامات كل 12 ساعة
4. Dتقييم طارئ من فريق سريري يمتلك مهارات الرعاية الحرجة

A patient with back pain develops numbness around the anus and genitals and new difficulty passing urine. Which condition should be suspected?

1. ACauda equina syndrome
2. BKidney stones
3. CSimple muscle strain
4. DConstipation

Which energy-conservation advice is most useful for a patient with severe COPD?

1. AHold the breath while lifting heavy objects
2. BSit down for tasks such as washing and dressing, and pace activities
3. CAvoid any activity at all, staying in a chair to save their energy
4. DDo all the household tasks quickly in the morning to get them done

The monitor of a patient with a permanent pacemaker shows pacing spikes, but none of them is followed by a QRS complex. What does this mean?

1. ANormal pacemaker function
2. BAtrial fibrillation
3. CFailure to sense
4. DFailure to capture

How does bladder training help urge incontinence?

1. AA catheter is used every night
2. BThe time between voids is slowly increased
3. CThe patient drinks as little as possible
4. DThe patient goes to the toilet every 15 minutes

After a TURP, a patient on bladder irrigation has bladder spasms. The drainage has slowed and contains clots, and the bag holds less than the irrigant given. What should the nurse do first?

1. AGive an antispasmodic and recheck in four hours
2. BEncourage the patient to strain to pass the clots
3. CTurn off the irrigation and leave the catheter alone
4. DSuspect a clot in the catheter and follow the protocol

A patient has taken oral prednisolone daily for many months. Why is this important before surgery?

1. ASteroids prevent all wound infections after surgery
2. BSteroids must always be stopped a full week before any type of surgery
3. CThey may need extra steroid cover to prevent an adrenal crisis
4. DSteroids make the anaesthetic drugs last much longer

A patient with suspected appendicitis says the pain suddenly eased, but an hour later has a temperature of 38,9 °C, a rigid abdomen and a pulse of 118/min. What does this suggest?

1. APerforation with peritonitis
2. BThe appendicitis has settled by itself
3. CA side effect of the analgesia given
4. DSimple constipation that needs a laxative