تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A patient on a continuous IV heparin infusion has new black, tarry stools and an aPTT well above the target range. What should the nurse do first?

1. ACheck the pump rate and leave the infusion running
2. BOffer an iron-rich meal to replace the lost blood
3. CStop the heparin infusion and inform the provider
4. DGive a dose of vitamin K by mouth

A patient taking an MAO inhibitor antidepressant is taught about diet. Which statement shows a need for further teaching?

1. A“A sudden severe headache is a warning sign.”
2. B“I can still eat aged cheese and cured salami.”
3. C“I will avoid tap beer and red wine.”
4. D“I will check with the pharmacist before cold remedies.”

How is a urine specimen for culture obtained from an indwelling catheter?

1. ABy removing the catheter and sending its tip for culture
2. BFrom the sampling port, after cleaning it, using aseptic technique
3. CFrom the urine already collected in the drainage bag at the bedside
4. DBy disconnecting the catheter from the drainage tubing

A patient with pneumonia has low blood pressure and a raised serum lactate. What does the raised lactate suggest?

1. APoor tissue perfusion, a sign of sepsis-related shock
2. BRecovery from the infection is beginning
3. CMild dehydration from poor intake, with no further concern
4. DA normal response to having a fever

هيموغلوبين مريض 7,8 g/dL (78 g/L). أي علامات تتوقعها الممرضة؟

1. Aصداع ورعاف ووجه أحمر
2. Bحكة واصفرار الجلد وبول داكن
3. Cبطء القلب واحمرار الجلد وارتفاع ضغط الدم
4. Dإرهاق وشحوب وسرعة في القلب وضيق نفس عند الجهد

A patient has a hemoglobin of 11,2 g/dL (112 g/L), an MCV of 64 fL, a normal ferritin and a normal-to-high red cell count. What is the most likely cause?

1. AAcute blood loss
2. BThalassemia trait
3. CIron deficiency
4. DVitamin B₁₂ deficiency

In suspected sepsis, what should ideally be collected before the first dose of antibiotics, as long as it does not delay treatment?

1. ABlood cultures
2. BA stool sample for occult blood
3. CA 24-hour urine collection
4. DA fasting cholesterol level

أيّ إجراء صحيح عند العناية بأنبوب صدري موصول بختم مائي؟

1. Aإزالة الماء من الزجاجة لمنع انسكابه
2. Bرفع الزجاجة فوق المريض لتفريغها
3. Cإغلاق الأنبوب بالملقط روتينيًا أثناء كل نقل أو تحريك للسرير
4. Dإبقاء زجاجة التصريف أسفل مستوى الصدر

Analysis of a pleural effusion shows it is an exudate (high protein and LDH compared with blood). Which cause is most likely?

1. ANephrotic syndrome with protein lost in urine
2. BHeart failure with raised venous pressure
3. CPneumonia or cancer affecting the pleura
4. DLiver cirrhosis with a low albumin

A patient with life-threatening asthma has not responded to repeated nebulised salbutamol (albuterol), ipratropium and steroids. Which drug is commonly given intravenously next?

1. AMorphine
2. BMagnesium sulfate
3. CMetoprolol
4. DIntravenous furosemide

Why is good blood pressure control important in chronic kidney disease?

1. AIt cures chronic kidney disease
2. BIt raises the haemoglobin level in the blood
3. CIt lowers the blood glucose
4. DIt slows the decline in kidney function

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. BSuspect a clot in the catheter and follow the protocol
3. CEncourage the patient to strain to pass the clots
4. DTurn off the irrigation and leave the catheter alone

How are skin staples usually removed from a healed incision?

1. AOnly the staples at each end, leaving the others for good
2. BAlternate staples first, then the rest if the wound holds
3. CThe staples are left in permanently under the skin
4. DAll staples at once by pulling each one straight up from the skin

A patient with long-standing chronic pancreatitis now has weight loss, thirst and passing large volumes of urine. What should the nurse check first?

1. APeak expiratory flow
2. BAbdominal girth
3. CCapillary blood glucose
4. DSerum amylase level