تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

يُظهر جهاز مراقبة القلب خطًا مستقيمًا (سكتة قلبية انقباضية) لدى مريض، لكن المريض جالس ويتحدث. ماذا تفعل الممرضة أولًا؟

1. Aفحص المريض ووصلات الأقطاب
2. Bبدء الضغطات الصدرية فورًا
3. Cتجهيز جهاز إزالة الرجفان لإعطاء صدمة
4. Dاستدعاء فريق توقف القلب

ترى ممرضة أن جرعة موصوفة غير آمنة. يقول الواصف أن تعطيها على أي حال. ماذا ينبغي أن تفعل الممرضة؟

1. Aإعطاء نصف الجرعة حلًّا وسطًا وتوثيق السبب
2. Bإعطاء الجرعة، لأن الواصف أصبح مسؤولًا عنها
3. Cتخطي الجرعة بصمت وعدم قول شيء لتجنب الخلاف
4. Dحجب الجرعة والتصعيد عبر التسلسل الإداري

How are neuromuscular blocking drugs, such as vecuronium, safely stored?

1. ASeparate from other drugs, with a warning that they cause paralysis
2. BMixed in the same bin as other high-use drugs
3. CNext to common IV antibiotics so they are easy to find
4. DIn the general stock cupboard with the other IV drugs and no special labels

A competent patient at high risk of falls insists on walking to the bathroom alone. What is the best nursing approach?

1. AApply wrist restraints so the patient stays in bed
2. BExplain the risks, agree on ways to reduce them, respect the decision and document
3. CTell the patient that walking alone is against hospital law
4. DRemove the patient’s shoes and walking aid so that they cannot walk alone

A patient starts high-dose prednisone. Which laboratory change should the nurse expect?

1. AA fall in the white cell count
2. BA fall in serum sodium
3. CA rise in serum potassium
4. DA rise in blood glucose

A patient with heavy alcohol use and a poor diet has a hemoglobin of 10,1 g/dL (101 g/L), an MCV of 110 fL and a low red cell folate. Which explanation fits best?

1. AIron deficiency from slow, chronic bleeding in the gut
2. BAnemia caused by long-standing chronic kidney disease
3. CThalassemia trait inherited from one of the parents
4. DFolate deficiency, made worse by a direct alcohol effect

After a needlestick injury from a patient known to have HIV, why must the nurse report it immediately?

1. AThe patient will need antibiotics
2. BThe nurse must be tested for HIV the same day to confirm infection
3. CThe needle must be sent for culture
4. DPost-exposure prophylaxis works best when started as soon as possible

Which sign is often a late finding in hypovolaemic shock in a young, previously fit adult?

1. AA slightly raised respiratory rate
2. BCool peripheries
3. CA fall in blood pressure
4. DA rise in heart rate

How is the jugular venous pressure usually assessed?

1. APatient standing with the neck flexed forward
2. BPatient lying completely flat with the head turned to the right
3. CPatient sitting upright with the arms raised above the head
4. DPatient reclined at 45° with the head turned slightly to the left

A patient regains a pulse after a ventricular fibrillation arrest that was probably caused by a heart attack. Which investigation is most urgent?

1. AAn abdominal ultrasound
2. BA lumbar puncture
3. CSpirometry
4. DA 12-lead ECG

قبل حلّ الخثرة الوريدي في السكتة، أيّ حد لضغط الدم يُستخدم عادةً؟

1. Aأعلى من نحو 200/120 mmHg
2. Bأقل من نحو 90/60 mmHg
3. Cأقل من نحو 185/110 mmHg
4. Dلا يوجد حد لضغط الدم

A patient with long-standing diabetes suddenly has many new floaters and painless loss of vision in one eye. What is most likely, and what is needed?

1. ANormal ageing of the lens, needing new glasses
2. BDry eyes, needing lubricating drops
3. CA migraine aura, needing pain relief
4. DA bleed into the eye from retinopathy, needing urgent review

أيّ عبارة تصف التحمّل (tolerance) للأفيونيات على أفضل وجه؟

1. Aلم يعد الدواء يسبب أي إمساك
2. Bالحاجة إلى جرعة أعلى مع الوقت للتأثير نفسه
3. Cلدى المريض رغبة قهرية في مزيد من الدواء
4. Dأصيب المريض بحساسية من الدواء

A patient with cirrhosis takes spironolactone and furosemide. Which blood result should the nurse report before the next dose?

1. APotassium 4,2 mmol/L
2. BSodium 141 mmol/L
3. CSodium 138 mmol/L
4. DPotassium 6,0 mmol/L