تحديد الأولويات والتفويض بأسلوب NCLEX: حزمة المراجعة المكثفة

A nurse has given rapid-acting insulin, and then learns that the patient’s meal tray will be 45 minutes late. What should the nurse do?

1. ATell the patient to wait and do nothing until the tray comes
2. BGet the patient some carbohydrate food now and check the glucose
3. CAsk the patient to walk around the ward until the food arrives
4. DGive a second, smaller dose of insulin when the meal tray finally arrives

An RN has five patients and a nursing assistant. One patient has just become short of breath. Which task should the RN delegate so that the RN can go to that patient?

1. AMorning vital signs on the four stable patients
2. BExplaining the new diagnosis to the breathless patient’s family
3. CGiving the breathless patient’s IV furosemide
4. DAssessing the breathless patient’s lung sounds

A patient with a severe latex allergy is booked for surgery. Which measure is commonly used?

1. AUse latex gloves only for short procedures
2. BWrap latex items in plastic before use
3. CGive the patient antihistamines before surgery and then use the normal supplies
4. DUse latex-free supplies and schedule the patient as the first case of the day

During a disaster, the hospital needs to free beds quickly. Which patient is the best candidate for early discharge?

1. AA patient on an IV heparin infusion that is still being adjusted
2. BA patient with ongoing chest pain awaiting cardiac tests
3. CA patient admitted overnight for observation who is now stable with normal tests
4. DA patient on a ventilator in the intensive care unit who is slowly improving

A healthy patient has a mildly raised CK after running a marathon yesterday, without dark urine or symptoms. What is the most likely explanation?

1. AThe patient has developed acute pancreatitis
2. BThe patient has developed acute hepatitis
3. CStrenuous exercise raised CK from skeletal muscle
4. DAn acute myocardial infarction has occurred

A patient on IV gentamicin has a trough level above the target, and the creatinine has risen since yesterday. The next dose is due. What is the best action?

1. AGive half of the dose and document the reason for it
2. BGive the dose now and recheck the levels next week
3. CHold the dose and report the results to the prescriber
4. DGive the dose with extra oral fluids to protect the kidneys

What should a patient be told before using sublingual glyceryl trinitrate (GTN, nitroglycerin) spray for angina?

1. ASwallow the spray rather than leaving it under the tongue
2. BUse it only after the pain has lasted over an hour, with the patient lying flat
3. CTake it with a large glass of milk to protect the stomach lining
4. DSit down before using it, as it can cause dizziness and low blood pressure

كان إخراج البول لدى مريض منخفضًا جدًا لمدة 12 ساعة وارتفع الكرياتينين بشدة. أي دواء في المخطط هو الأرجح أن يحتاج إلى مراجعة؟

1. Aمكمّل فيتامينات
2. Bكريم مرطّب
3. Cدواء مضاد للالتهاب غير ستيرويدي مثل إيبوبروفين
4. Dالباراسيتامول بالجرعات المعتادة

Which ECG pattern is typical of acute pericarditis?

1. AST elevation only in leads II, III and aVF with Q waves
2. BA sawtooth baseline with a regular ventricular rate
3. CTall peaked T waves with a wide QRS
4. DWidespread saddle-shaped ST elevation with PR depression

Which task for a stable patient with heart failure can the registered nurse most appropriately delegate to a healthcare assistant (unlicensed assistive personnel)?

1. ADeciding whether to give the furosemide dose
2. BAssessing lung sounds for new crackles
3. CTeaching the patient about a low-salt diet
4. DMeasuring and recording the morning weight

Why are patients with an acute spinal cord injury at high risk of deep vein thrombosis?

1. AThe injury makes the blood too thin to clot properly in the veins
2. BThey usually take oestrogen as part of their treatment
3. CSpinal injuries always damage the large veins of the legs
4. DParalysed leg muscles no longer pump blood back to the heart

A day after a total thyroidectomy, a patient has tingling lips, a positive Chvostek's sign and a corrected calcium of 1,85 mmol/L (about 7,4 mg/dL). What does the nurse expect?

1. AA loop diuretic to remove the extra calcium
2. BIV calcium gluconate and monitoring for laryngospasm
3. CIV potassium chloride and a fluid restriction
4. DOral levothyroxine, with a recheck of the calcium in a month

أيّ درجة تُستخدم لتقييم الخطر في نزف السبيل الهضمي العلوي قبل التنظير؟

1. Aدرجة غلاسكو–بلاتشفورد
2. Bدرجة واترلو لخطر قرحة الضغط
3. Cدرجة ويلز لخثار الأوردة العميقة
4. Dمقياس غلاسكو للغيبوبة

مريض لديه دوالي مريء معروفة يتقيأ كميات كبيرة من الدم الطازج. ما العلاجات التي ينبغي أن تتوقعها الممرضة قبل التنظير؟

1. Aمضاد التهاب غير ستيرويدي فموي للألم ووجبة غنية بالبروتين
2. Bبلعة باريوم عاجلة قبل أي علاج دوائي
3. Cتسريب سريع للمحلول الملحي حتى ضغط دم مرتفع
4. Dالأوكتريوتيد أو التيرليبريسين، مع مضادات حيوية وريدية، أثناء الإنعاش