NCLEX-PN-शैली के अभ्यास प्रश्न (LPN/LVN): क्रैम पैक

Teaching a patient how to inject insulin mainly involves which domain of learning?

1. AAffective
2. BSpiritual
3. CCognitive
4. DPsychomotor

In an emergency a doctor gives a verbal order for a medicine. What should the nurse do?

1. ARefuse to give any medicine until a written prescription has been completed
2. BAsk another nurse to remember the order
3. CGive it and tell the doctor nothing more
4. DWrite it down, read it back and make sure it is signed later as per policy

When should the transparent dressing over a peripheral IV site be changed?

1. AEvery hour, so the site can be cleaned again
2. BOnly when the patient asks for a new dressing
3. CWhen it is damp, loose or visibly soiled
4. DOnly when the IV catheter is removed, whatever its state

A patient on oxygen needs an MRI scan. Which plan is safe?

1. ATake the usual steel cylinder into the room if it is tightly strapped to the trolley frame
2. BRemove the oxygen for the scan without telling anyone
3. CUse only MRI-safe equipment, and never take a standard steel oxygen cylinder into the scanner room
4. DLeave the steel cylinder on the patient’s bed during the scan

A patient with heart failure gained 2 kg (about 4 lb) since yesterday and is more breathless when lying down. What should the nurse do first?

1. ARecord the weight on the chart and recheck it at the next weekly weigh-in
2. BAssess the lungs, oxygen saturation and swelling, then inform the provider
3. CLay the patient flat to help them breathe more easily
4. DEncourage extra fluids to correct the weight change

A patient receiving comfort-focused end-of-life care is distressed by breathlessness. Which approach is most appropriate?

1. AWithhold all opioids because they may slow breathing
2. BLeave the patient alone so they can rest
3. CGive prescribed opioids and use positioning and a fan to relieve breathlessness
4. DStart a series of aggressive tests to find the exact cause of the breathlessness

A patient is admitted with cellulitis of the leg. Why might the nurse mark the edge of the redness on the skin?

1. ATo monitor whether the infection is spreading or improving
2. BTo show the surgeon exactly where to make the incision
3. CTo help the patient find the sore area
4. DTo mark the site for an injection

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

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

A patient has a hot, swollen big toe. The serum uric acid is normal. Which statement is correct?

1. AGout is still possible, as urate can be normal in an attack
2. BGout is certain, as a normal urate proves the diagnosis
3. CGout is ruled out, as uric acid is always high in an attack
4. DGout can only be diagnosed with a CT scan of the foot

A patient without symptoms has a finger-stick glucose of 340 mg/dL (18.9 mmol/L). The previous values were normal, and the patient has just peeled an orange. What should the nurse do first?

1. AAsk the laboratory to measure HbA1c from the same drop of blood
2. BHave the patient wash and dry their hands, then repeat the test
3. CGive a correction dose of insulin for a glucose of 340 mg/dL
4. DReport the result as a new diagnosis of diabetes mellitus

Why are patients taking simvastatin often advised to avoid large amounts of grapefruit juice?

1. AGrapefruit inhibits CYP3A4 in the gut, raising simvastatin levels and myopathy risk
2. BGrapefruit makes the tablet dissolve in the mouth
3. CGrapefruit blocks cholesterol absorption and causes low cholesterol
4. DGrapefruit speeds up simvastatin breakdown in the liver, so the drug stops working

A man on long-term testosterone therapy has a rising haematocrit. Why is this important?

1. AA high haematocrit shows that the testosterone is not being absorbed
2. BTestosterone raises red cell production, increasing clot risk
3. CIt means the testosterone dose is too low
4. DIt is a sign of liver failure caused by testosterone

A patient with bronchiectasis of the right lower lobe is taught postural drainage. How should they be positioned?

1. AFlat on the back with the arms raised
2. BWith the affected lobe lowest so it fills with mucus
3. CSitting fully upright at all times
4. DWith the affected lobe uppermost so gravity drains it

A patient with severe sepsis becomes increasingly breathless over 24 hours. SpO₂ stays low despite high-flow oxygen, and the chest X-ray shows bilateral infiltrates. The heart function is normal. Which condition is most likely?

1. ASpontaneous pneumothorax
2. BAn acute asthma attack
3. CAcute respiratory distress syndrome
4. DAcute left ventricular failure after an MI

DKA उपचार के दौरान ग्लूकोज़ लगभग 14 mmol/L (लगभग 250 mg/dL) से नीचे गिर जाता है पर कीटोन अब भी बढ़े हुए हैं। आमतौर पर क्या होता है?

1. Aद्रव अधिभार से बचने के लिए सभी IV द्रव बंद कर दिए जाते हैं
2. Bइंसुलिन इन्फ़्यूज़न तुरंत बंद कर दिया जाता है
3. Cमरीज़ भोजन करता है और IV उपचार बंद हो जाता है
4. Dद्रवों में ग्लूकोज़ मिलाया जाता है; इंसुलिन जारी रहता है

A patient with a long-term catheter has fever and rigors, and a catheter UTI is suspected. Which action is recommended before starting antibiotics?

1. AReplace the catheter and take a sample from the new one
2. BFlush the catheter with saline and continue
3. CTake a sample from the drainage bag and send it to the lab
4. DRemove the catheter and leave it out permanently

Which statement about fatigue during radiotherapy is correct?

1. AIt means the radiotherapy has failed
2. BIt is caused by the patient becoming radioactive
3. CIt occurs only after the first session and then disappears completely
4. DIt often builds during the course and can last for weeks

A few hours after thyroid surgery, a patient's neck swells rapidly and they become short of breath with stridor. What is most likely?

1. ANormal swelling after neck surgery
2. BLow blood calcium from the surgery
3. CA haematoma pressing on the airway
4. DAn allergy to the wound dressing

Which baby is at greatest risk of early-onset group B streptococcal infection?

1. AA baby whose mother was GBS-negative at 36 weeks
2. BA baby of a GBS-positive mother with no antibiotics
3. CA baby born at 40 weeks to a mother with no risk factors
4. DA baby born by planned caesarean with intact membranes

At a booking visit, a woman says she drinks heavily most weekends. Which nursing response is most appropriate?

1. AExplain the risks and refer her for support to stop
2. BTell her the damage is done, so stopping will not help
3. CReassure her that weekend drinking is safe if she avoids weekdays
4. DAdvise her to change to beer, which has less alcohol

Which signs suggest hypoglycaemia in a young child with diabetes?

1. AThirst, passing large amounts of urine and a fruity breath smell
2. BDeep, rapid breathing with abdominal pain and vomiting
3. CA slow onset of dry skin and flushed cheeks over several days
4. DShakiness, sweating, pallor and a sudden change in behaviour

An infant with a large VSD now breathes faster, sweats during feeds and has gained 300 g overnight with puffy eyelids. What does this most likely indicate?

1. AWorsening heart failure with fluid retention
2. BAn allergic reaction to the new high-energy formula started yesterday
3. CGood growth thanks to improved feeding
4. DDehydration due to sweating during feeds

In families of people with schizophrenia, which pattern of "high expressed emotion" is linked to a higher rate of relapse?

1. ACalm, supportive and warm communication
2. BRegular contact with the care team and other families
3. CEncouraging the patient to take part in activities
4. DFrequent criticism, hostility and emotional over-involvement

A patient asks the nurse to pray with her before her ECT. The nurse does not share her religion. What is the most appropriate response?

1. ATry to persuade her to adopt the nurse's own beliefs
2. BIgnore the request politely and change the subject to the procedure itself
3. CRespect the request, join in if comfortable, and offer to call the chaplain
4. DTell her that religion has no place in hospital care

अभ्यास प्रश्न (काल्पनिक मान, नैदानिक मार्गदर्शन नहीं)। एक खुराक 02:45 (24-घंटे की घड़ी) पर चार्ट की गई है। 12-घंटे की घड़ी में वही समय कौन-सी प्रविष्टि है? उसे चुनिए।

1. 12:45 AM
2. 22:45 PM
3. 34:45 AM
4. 41:45 AM

अभ्यास प्रश्न (काल्पनिक मान, नैदानिक मार्गदर्शन नहीं)। एक मेंटेनेंस इन्फ्यूज़न बिना रुके 50 mL/h पर चलता है। यह 24 घंटे में कितने लीटर V देता है?

एपिनेफ्रिन (एड्रेनालिन) की एक प्रीफ़िल्ड सिरिंज पर 1:10 000 (0.1 mg/mL) लिखा है। कार्डियक अरेस्ट में निर्धारित खुराक 1 mg IV है। आप कितना आयतन V देंगे?

एक इन्फ्यूज़न में 250 mL में दवा की 25000 इकाइयाँ हैं। निर्धारित 1200 इकाइयाँ प्रति घंटा है। आप पंप को mL/h में किस दर R पर सेट करेंगे?

20 बूँद/mL वाले सेट से 500 mL को 10 घंटों में दें। ड्रिप दर R बूँद प्रति मिनट में ज्ञात करें। निकटतम पूर्ण संख्या तक पूर्णांकित कीजिए।

6 घंटों में 500 mL का आदेश दिया गया था। 2 घंटे बाद आप पाते हैं कि बैग में अभी 370 mL बचा है, और आदेश को फिर भी समय पर पूरा होना है। मूल पंप दर को कितने प्रतिशत Δ बढ़ाना होगा?

अभ्यास प्रश्न (काल्पनिक मान, नैदानिक मार्गदर्शन नहीं)। रिकॉर्ड एक 8-घंटे की शिफ़्ट के लिए रोगी का अंतर्ग्रहण और निर्गम दिखाता है। रोगी का भार 55 kg है। औसत मूत्र निर्गम U mL/kg/h में ज्ञात कीजिए। दो दशमलव स्थानों तक पूर्णांकित करें।

अभ्यास प्रश्न (काल्पनिक मान, नैदानिक मार्गदर्शन नहीं)। एक 500 mL बैग पंप से 50 mL/h पर चल रहा है। 13:00 पर 100 mL पहले ही दिए जा चुके हैं। बैग खाली होने में कितने घंटे t लगेंगे? एक दशमलव स्थान तक पूर्णांकित करें।

अभ्यास प्रश्न (काल्पनिक मान, नैदानिक मार्गदर्शन नहीं)। एक रोगी की नाड़ी 86/min और रक्तचाप 104/62 mmHg है। शॉक इंडेक्स SI = HR/SBP ज्ञात कीजिए। दो दशमलव स्थान तक पूर्णांकित कीजिए।

अभ्यास प्रश्न (काल्पनिक मान, नैदानिक मार्गदर्शन नहीं)। टीम का लक्ष्य कम से कम 60 mmHg का माध्य धमनी दाब है। एक रोगी का सिस्टोलिक दाब 94 mmHg है। MAP = (SBP + 2·DBP)/3 का उपयोग करके, सबसे कम डायस्टोलिक दाब DBP क्या है जो फिर भी 60 mmHg का MAP देता है?