تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A nursing assistant offers to suction a patient’s new tracheostomy. Which response from the RN is best?

1. A“Ask the patient’s family to do the suctioning today.”
2. B“Suctioning a new tracheostomy is my task; I will do it myself.”
3. C“Thank you, please suction him as needed and tell me how it went.”
4. D“Leave the suctioning until the next shift arrives.”

أي طفل ينبغي أن تراه الممرضة أولًا؟

1. Aطفل في سن المدرسة في ساقه جبيرة ويطلب شرابًا
2. Bمراهق مصاب بالربو ذروة جريانه 90% من أفضل قيمة شخصية له
3. Cرضيع مصاب بالفيروس المخلوي التنفسي (RSV) لديه توسع في المنخرين وانسحاب في الصدر وإشباع أكسجين SpO₂ 89%
4. Dطفل دارج حرارته 38,4 °C ويلعب بالألعاب

Where should the dispersive (grounding) pad for electrosurgery be placed?

1. AOn skin that is wet with antiseptic prep
2. BOver an area with scar tissue or a tattoo, so that the pad does not slip
3. COver a bony prominence such as the hip bone
4. DOn clean, dry skin over a well-perfused muscle, close to the surgical site

An 84-year-old resident with an indwelling catheter suddenly becomes confused but has no fever. What should the nurse consider?

1. AA sedative is needed to keep the resident calm
2. BThe confusion is part of normal aging at this age and needs no further action
3. CInfection can be ruled out because there is no fever
4. DAn infection may present as confusion in older adults, so assess further and report

A patient taking spironolactone asks about using a salt substitute. What should the nurse explain?

1. ASalt substitutes are fine as long as the patient drinks more water
2. BSalt substitutes protect against the potassium loss caused by this drug
3. CMost salt substitutes contain potassium and can raise the level too high
4. DSalt substitutes are safe because they contain only sodium chloride

A child with sickle cell disease and a recent viral illness is pale and tired. The hemoglobin has fallen sharply, and the reticulocyte count is very low. What is the most likely problem?

1. AA normal finding in sickle cell disease
2. BIron deficiency from a poor diet over months
3. CA vaso-occlusive pain crisis in the bones
4. DAn aplastic crisis, often caused by parvovirus B19

A patient with sickle cell disease is admitted with a painful crisis. What is a key early nursing priority?

1. ADelaying pain relief until a diagnosis is confirmed
2. BGiving prompt, effective analgesia
3. CApplying cold packs to the painful areas
4. DRestricting oral fluids

يصبح مريض مسن مصاب بكسر في الورك ضيق النفس ومشوشًا، مع طفح نمشي على الصدر بعد يومين من الإصابة. أي مضاعفة يجب الاشتباه بها؟

1. Aمتلازمة الحيّز
2. Bمتلازمة الانصمام الدهني
3. Cقرحة الضغط
4. Dعدوى المسالك البولية

A patient with COPD is prescribed long-term oxygen therapy. How many hours a day is it usually needed to improve survival?

1. AOnly during meals
2. BAbout one hour each morning
3. COnly when walking outside
4. DAt least 15 hours a day

A 70-year-old man has a small abdominal aortic aneurysm found on screening and is placed under surveillance. Which advice is most important?

1. AStop all blood pressure medicines to avoid low pressure
2. BAvoid all exercise and lifting for the rest of his life to protect the aorta
3. CHave the aneurysm repaired immediately, whatever its size or growth rate
4. DStop smoking, control BP and seek help at once for sudden back pain

لدى مريض عمى نصفي متماثل الجانب بعد سكتة. كيف ينبغي أن تساعده الممرضة في البداية؟

1. Aالاقتراب من الجانب المبصر وتعليمه إدارة الرأس للمسح
2. Bوضع جرس النداء والمشروبات في الجانب غير المبصر لتدريبه
3. Cتغطية العين في الجانب المصاب بلصاقة
4. Dإبقاء الغرفة مظلمة لتقليل التنبيه البصري

A patient with acromegaly snores loudly, stops breathing at times in sleep and is sleepy during the day. What is most likely?

1. AAn anxiety disorder
2. BNarcolepsy
3. CNormal snoring
4. DObstructive sleep apnoea

أيّ فئة دوائية تُستخدم عادةً لتقليل الحموضة بعد المعالجة التنظيرية لقرحة هضمية نازفة؟

1. Aالمدرّات العروية
2. Bمضادات الهيستامين H1 مثل السيتريزين
3. Cمثبطات مضخة البروتون
4. Dحاصرات بيتا

During bowel preparation, an older patient becomes dizzy and confused. Blood tests show sodium 127 mmol/L. What should the nurse do?

1. ARecord it and continue as planned, as this is expected
2. BEncourage plain water only, as much as possible
3. CGive the rest of the preparation more quickly
4. DStop the preparation and escalate to the medical team