NCLEX-शैली की प्राथमिकता निर्धारण और प्रत्यायोजन: क्रैम पैक

A patient has a new plaster cast that is still drying. How should the nurse handle it?

1. AWith the palms of the hands, not the fingertips
2. BBy resting it directly on a hard surface
3. CWith the fingertips, pressing firmly to test it
4. DBy covering it tightly with a plastic sheet

A competent adult patient refuses a blood transfusion for religious reasons. What should the nurse do?

1. AAsk the family to persuade the patient until they agree
2. BTell the patient that refusing treatment is not allowed in hospital
3. CRespect the refusal, check the patient understands the risks and inform the provider
4. DGive the transfusion while the patient is asleep, because saving their life comes first

A small spill of blood is found on the floor. How should it be cleaned?

1. AWipe it up quickly with a dry cloth using bare hands, then wash the hands well
2. BWear gloves, absorb the blood, then clean the area with an approved disinfectant
3. CCover it with a clean sheet and keep working
4. DLeave it until housekeeping arrives the next morning

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

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

A patient has had severe watery diarrhea for 4 days. Which laboratory pattern would the nurse expect?

1. ALow glucose and high magnesium
2. BHigh potassium and high bicarbonate
3. CHigh sodium and high calcium
4. DLow potassium and low bicarbonate

दो सप्ताह पहले बड़ा रक्त आधान पाए रोगी में HbA1c परिणाम भ्रामक क्यों हो सकता है?

1. Aआधान हमेशा HbA1c को झूठे उच्च स्तर तक बढ़ाते हैं
2. BHbA1c हर स्थिति में सटीक होता है
3. Cबहुत-सी लाल कोशिकाएँ दाता की हैं, जो रोगी के ग्लूकोज़ के संपर्क में नहीं आईं
4. DHbA1c श्वेत कोशिकाओं पर शर्करा मापता है, लाल कोशिकाओं पर नहीं

During a vesicant chemotherapy infusion, the patient reports burning and swelling at the cannula site. What should the nurse do first?

1. AStop the infusion straight away and follow the extravasation protocol
2. BFlush the cannula hard with saline
3. CIncrease the rate so that the infusion finishes as quickly as possible
4. DApply a warm pack and continue the infusion

एक मरीज़ की रक्त जाँच में पोटैशियम 6.8 mmol/L है और ECG में नुकीली T तरंगें दिखती हैं। कौन-सा उपचार हृदय की सबसे जल्दी रक्षा करता है?

1. Aअगले दिन फ़्यूरोसेमाइड गोलियाँ
2. Bकेवल कम-पोटैशियम आहार
3. Cमुँह से पोटैशियम सप्लीमेंट
4. DIV कैल्शियम ग्लूकोनेट

Why is a raised serum lactate concerning in a patient with shock?

1. AIt suggests tissues are short of oxygen and using anaerobic metabolism
2. BIt shows only that the patient has eaten a large meal in the past hour
3. CIt means the kidneys are working harder than normal to clear fluid
4. DIt confirms a bacterial infection is present

A patient with lung cancer develops swelling of the face and arms, distended neck and chest veins and breathlessness that is worse when bending forward. What is the most likely cause?

1. AA deep vein thrombosis in the leg
2. BAn allergic reaction to chemotherapy
3. CSuperior vena cava obstruction
4. DRight-sided heart failure

Why is levodopa combined with carbidopa (or benserazide)?

1. ATo stop levodopa being converted to dopamine outside the brain
2. BTo prevent tolerance from developing to levodopa over time
3. CTo add a separate effect that reduces the resting tremor directly
4. DTo make levodopa cross into the brain more slowly and evenly

वैल्प्रोएट लेने वाली मिर्गी की महिला कहती है कि वह गर्भावस्था की योजना बना रही है। कौन-सी प्रतिक्रिया सबसे उपयुक्त है?

1. Aसलाह देना कि इसे अचानक बंद न करें और तत्काल विशेषज्ञ समीक्षा कराएँ
2. Bशिशु को दौरों से बचाने के लिए खुराक दोगुनी करने का सुझाव देना
3. Cउसे आश्वस्त करना कि वैल्प्रोएट पूरी गर्भावस्था में सुरक्षित है
4. Dउसे आज से वैल्प्रोएट पूरी तरह बंद करने को कहना

Why are accurate fluid balance charts kept after major surgery?

1. ATo record when visitors come and go
2. BTo check how far the patient has walked and how often they get out of bed
3. CTo decide which meal the patient will have next
4. DTo detect dehydration, fluid overload or kidney problems early

Which group of signs suggests that a patient is entering the last days of life?

1. AHigh blood pressure and very fast weight gain
2. BReduced intake, mottled skin and changes in breathing
3. CClearer thinking and increased movement
4. DRising appetite, more energy and normal skin colour and warmth