NCLEX-शैली की प्राथमिकता निर्धारण और प्रत्यायोजन: क्रैम पैक

On a pediatric unit, which child does the nurse assess first?

1. AA child in a new arm cast with pink, warm fingers and pain of 5/10
2. BA child with a temperature of 38.2 °C after vaccination
3. CA child with asthma who is now quiet with very little air movement
4. DA child with croup who has a barking cough but no stridor at rest

During an infusion of a thrombolytic drug for stroke, the patient develops a severe headache and starts vomiting. What should the nurse do first?

1. AStop the infusion and inform the provider at once
2. BContinue the infusion, because headache is expected
3. CGive a dose of aspirin for the headache
4. DSlow the infusion and give an antiemetic as prescribed

संदिग्ध टीबी वाला मरीज़ नेगेटिव-प्रेशर कमरे में है। कौन-सी प्रथा सही है?

1. Aदरवाज़ा खुला रखना ताकि कर्मचारी हर समय मरीज़ को देख सकें
2. Bआगंतुकों को बिना किसी सुरक्षा के भीतर आने देना
3. Cरात में कमरे का वेंटिलेशन बंद कर देना
4. Dदरवाज़ा बंद रखना, केवल भीतर आते या बाहर जाते समय को छोड़कर

A nurse asks a colleague to “just glance” at an insulin infusion before starting it. What makes a check truly independent?

1. AThe second nurse checks the order, drug, dose and pump settings separately without being told the answer
2. BThe second nurse looks at the bag label from the doorway
3. CThe first nurse reads the details aloud and the second agrees
4. DThe second nurse signs the record after the infusion has already been started by the first

A patient with type 2 diabetes starts prednisone each morning. When is the glucose most likely to be highest?

1. AIn the afternoon and evening
2. BIn the early morning, before the dose
3. CThe glucose will not change
4. DAt midnight only

A woman with preeclampsia is receiving IV magnesium sulfate. Her urine output has fallen and her creatinine is rising. Why is this a concern?

1. AMagnesium causes potassium loss, so the kidneys release more fluid
2. BMagnesium is broken down by the liver, so it will stop working soon
3. CPoor kidney function makes the magnesium level fall quickly
4. DMagnesium is excreted by the kidneys, so it can build up to toxic levels

एक बुज़ुर्ग मरीज़ को वार्ड में गिरने का उच्च जोखिम है। कौन-सी नर्सिंग कार्रवाई सबसे उपयुक्त है?

1. Aहर मरीज़ के लिए स्वतः बेड रेल का उपयोग करें
2. Bकॉल बेल और सामान पहुँच में रखें और उनींदापन पैदा करने वाली दवाओं की समीक्षा करें
3. Cमरीज़ को हर समय बिस्तर तक सीमित रखें
4. Dटूटने से बचाने के लिए मरीज़ का चश्मा हटा दें

A hypotensive postoperative patient is given a fluid bolus. Which findings suggest a good response?

1. AThe respiratory rate rises and new lung crackles appear
2. BThe heart rate rises further and the patient becomes more confused
3. CThe capillary refill time becomes longer
4. DThe heart rate falls, blood pressure rises and urine output improves

दाएँ निलय के इन्फार्क्शन में नाइट्रेट अत्यधिक सावधानी से क्यों उपयोग किए जाते हैं?

1. Aइस प्रकार के इन्फार्क्ट में नाइट्रेट खतरनाक हाइपरकैलीमिया करते हैं
2. Bदायाँ निलय प्रभावित होने पर नाइट्रेट अवशोषित नहीं होते
3. Cदायाँ निलय प्रीलोड पर निर्भर होता है, इसलिए रक्तचाप तेज़ी से गिर सकता है
4. Dनाइट्रेट इन्फार्क्ट को बाएँ निलय में फैला देते हैं

Twelve hours after a coronary stent, a patient has sudden severe chest pain again with new ST elevation in the same leads. What is the most likely cause?

1. APericarditis from the catheter
2. BIndigestion from the hospital meal
3. CNormal pain from the procedure site
4. DAcute stent thrombosis

After pressing the plunger of an insulin pen, what should the patient do?

1. AKeep the needle in the skin for about 10 seconds
2. BPull the needle out at once and rub the site firmly
3. CInject a second dose straight away to be sure
4. DLeave the needle on the pen for the next injection

A nurse teaches a woman with recurrent UTIs. Which statement shows a need for further teaching?

1. A"I will hold my urine for as long as I can."
2. B"I will wipe from front to back."
3. C"I will drink enough fluids during the day."
4. D"I will pass urine soon after sex."

A patient has taken oral prednisolone daily for many months. Why is this important before surgery?

1. AThey may need extra steroid cover to prevent an adrenal crisis
2. BSteroids make the anaesthetic drugs last much longer
3. CSteroids prevent all wound infections after surgery
4. DSteroids must always be stopped a full week before any type of surgery

A patient with facial burns from a house fire was talking normally on arrival. Two hours later, the voice is hoarse and there is stridor. What should the nurse do?

1. AEncourage the patient to rest the voice and reassess tomorrow
2. BLay the patient flat to help them sleep
3. CGive a warm drink to soothe the throat
4. DCall for urgent anaesthetic help, as the airway is swelling