تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

يرفض مساعد تمريض مهمة مفوَّضة قائلًا إنه لم يُدرَّب عليها. ما أفضل استجابة من الممرضة؟

1. Aإخبار المساعد بأنها في الوصف الوظيفي ويجب إنجازها
2. Bشكر المساعد، والتأكد من إنجاز المهمة بأمان، وترتيب التدريب
3. Cإبلاغ المديرة عن المساعد لرفضه مهمة
4. Dترك المهمة للوردية التالية، حين يكون شخص مدرَّب مناوبًا

An older patient with heart failure is receiving a second unit of blood. She becomes breathless, with crackles in both lungs and a rising blood pressure. What is most likely happening?

1. AA mild allergic reaction with hives
2. BAn expected effect of the first unit
3. CTransfusion-associated circulatory overload
4. DHypoglycemia caused by the stored blood product

A patient walking with a gait belt suddenly starts to fall. What should the nurse do?

1. ALet go of the belt and run to call for help
2. BGrab the patient under both arms and try hard to keep them standing up
3. CPull the patient backwards quickly toward the bed
4. DHold the belt, widen the stance and ease the patient gently to the floor

A nurse has just started a unit of red blood cells when a colleague asks for urgent help with another patient. What is the best action?

1. AStay with the transfusing patient for the first 15 minutes and ask another nurse to help
2. BSpeed up the transfusion so it finishes sooner
3. CLeave to help the other patient, and check the transfusion again in about an hour
4. DPause the transfusion until the nurse is free again

مريض بتشمع الكبد ألبومين مصله 2,2 g/dL (22 g/L). أي علامة هي الأكثر ارتباطًا بذلك؟

1. Aالوذمة والاستسقاء
2. Bارتفاع ضغط الدم
3. Cزيادة كمية البول
4. Dفرط بوتاسيوم الدم

Weeks after neck surgery, a patient has muscle cramps and tingling. Calcium is low, phosphate is high and parathyroid hormone (PTH) is low. Which condition fits best?

1. APrimary hyperparathyroidism
2. BVitamin D toxicity
3. CChronic kidney disease
4. DHypoparathyroidism

A patient receives IV furosemide for fluid overload. Which findings show the treatment is working?

1. AA rise in weight and more lung crackles
2. BIncreased urine output, less breathlessness and a falling weight
3. CFalling urine output, new ankle swelling and a rise in weight
4. DA rise in blood pressure and a new cough

Soon after starting chemotherapy for a high-grade lymphoma, a patient has rising potassium, phosphate and uric acid with falling urine output. What is the most likely cause?

1. ASyndrome of inappropriate ADH secretion
2. BAdrenal insufficiency
3. CTumour lysis syndrome
4. DRefeeding syndrome

مريض بدأ للتو دواءً خافضًا للضغط يشعر بالدوار عند النهوض من السرير. ما النصيحة الصحيحة؟

1. Aالتوقف عن تناول القرص دون إخبار الطبيب أو الممرضة
2. Bالوقوف بسرعة كي يبقى الدم متحركًا
3. Cتناول جرعة مضاعفة في الصباح التالي بدلًا من ذلك
4. Dالجلوس على حافة السرير لحظة قبل الوقوف

مريض بدأ مثبط الإنزيم المحوِّل للأنجيوتنسين أمس يصاب بتورم في الشفتين واللسان وبحة في الصوت. ماذا ينبغي أن تفعل الممرضة أولًا؟

1. Aشرح أن هذا أثر جانبي متوقع وغير ضار
2. Bإعطاء الجرعة التالية مبكرًا لأن ذلك سيهدئ التورم سريعًا
3. Cوضع الثلج على الشفتين وإعادة التقييم في الصباح
4. Dتقييم المجرى الهوائي وطلب مساعدة عاجلة وحجب الجرعات اللاحقة

After a lumbar discectomy, which finding should the nurse report promptly?

1. ANew weakness or numbness in the legs
2. BA dry, intact wound dressing
3. CMild pain at the wound site
4. DStiffness when getting out of bed

The nurse has four patients with diabetes. Which one needs to be seen first?

1. AA patient with a glucose of 14 mmol/L (252 mg/dL) who feels well and is eating
2. BA patient with a glucose of 2,8 mmol/L (50 mg/dL) who is sweaty and confused
3. CA newly diagnosed patient asking about which foods to eat
4. DA patient waiting for a routine HbA1c test

A patient received IV morphine 20 minutes ago and the surgical consent form has not been signed. What should the nurse do?

1. AAsk the patient to sign quickly before they get sleepier
2. BAsk a relative to sign instead of the patient
3. CSign the form on the patient's behalf as a witness
4. DTell the surgeon, as the patient may not be able to consent now

A patient with gallstones has a temperature of 39 °C with rigors, jaundice and right upper abdominal pain. What should the nurse suspect?

1. AUncomplicated reflux
2. BSimple biliary colic
3. CAcute hepatitis A
4. DAscending cholangitis