NCLEX-शैली की प्राथमिकता निर्धारण और प्रत्यायोजन: क्रैम पैक

A conscious patient with hypoglycemia drank juice 15 minutes ago. The glucose is now 62 mg/dL (3.4 mmol/L). What should the nurse do next?

1. ARecord the result and recheck the glucose at the usual time before the evening meal
2. BGive another serving of fast-acting carbohydrate and recheck in 15 minutes
3. CWait another hour, because juice can take a long time to work
4. DGive the next scheduled dose of rapid-acting insulin with the meal

Which finding after a laparoscopic cholecystectomy is expected and needs only reassurance and comfort measures?

1. AA heart rate of 125/min with a falling blood pressure
2. BIncreasing abdominal pain with a temperature of 39 °C
3. CRight shoulder pain from the gas used during surgery
4. DYellow skin with dark urine on the second day

Which IV fluid can be given with packed red blood cells in the same line?

1. A5% dextrose in water
2. B0.9% sodium chloride
3. C5% dextrose in 0.45% sodium chloride
4. DLactated Ringer’s (Hartmann’s) solution

A chemical cloud has been released near the hospital, and authorities order “shelter in place”. What should staff do?

1. ASend all visitors home through the main entrance
2. BKeep everyone inside, close windows and doors and shut off outside air intake
3. CEvacuate all patients into the car park at once
4. DOpen the windows to let fresh air into the wards and dilute the chemical

When should a blood specimen tube be labeled?

1. AIn the laboratory, by the staff who receive the unlabeled sample
2. BAt the bedside, in the patient's presence, using two identifiers
3. CAt the nurses' station, after all samples for the shift are drawn
4. DBefore entering the room, so tubes are ready for the next patients

A nursing student has a positive interferon-gamma release assay (IGRA) for tuberculosis, no symptoms and a normal chest X-ray. What does this most likely mean?

1. APast BCG vaccination only, with no infection
2. BLatent TB infection, which is not contagious
3. CActive pulmonary TB, which is contagious
4. DA false result, as the test does not detect TB

थायरॉइड सर्जरी के बाद एक मरीज़ को मुँह के आसपास झुनझुनी और मांसपेशियों में ऐंठन है। किस इलेक्ट्रोलाइट समस्या का संदेह होना चाहिए?

1. Aहाइपरनेट्रीमिया
2. Bहाइपोकैल्सीमिया
3. Cहाइपरकैलीमिया
4. Dहाइपरमैग्नेसीमिया

गंभीर दमा वाला एक मरीज़ शांत हो जाता है, "मूक छाती" (silent chest), थकावट और गिरती श्वसन दर के साथ। यह क्या दर्शाता है?

1. Aदौरे में सुधार, क्योंकि ब्रोंकोस्पाज़्म शांत होता है और वायुमार्ग शिथिल होते हैं
2. Bनेबुलाइज़र के बाद सामान्य स्वास्थ्य-लाभ
3. Cआसन्न श्वसन रोध (respiratory arrest) के साथ जानलेवा दमा
4. Dकेवल चिंता

A patient with heart failure starts dapagliflozin, an SGLT2 inhibitor. Which teaching is most relevant?

1. AExpect the urine to turn bright orange and stain underwear and clothes
2. BKeep the genital area clean, as fungal infections are more common
3. CTake an extra dose if the ankles swell
4. DAvoid drinking any fluids at all for the first week of treatment

Four surgical patients need VTE prevention. For which patient is mechanical prophylaxis alone most appropriate?

1. AAn obese patient after hip surgery
2. BA patient with cancer having bowel surgery
3. CA patient after an uncomplicated knee replacement
4. DA patient who had a brain haemorrhage two days ago

Which CSF result is most typical of bacterial meningitis?

1. AClear fluid with normal cells, glucose and protein
2. BClear fluid, many lymphocytes, normal glucose and slightly raised protein
3. CCloudy fluid, many neutrophils, low glucose and high protein
4. DBlood-stained fluid that clears in later tubes

A patient had a witnessed tonic-clonic seizure. Afterwards their left arm is weak, and the weakness improves over the next few hours. What is the best interpretation?

1. ANormal postictal tiredness that needs no further assessment or imaging at all
2. BPossible postictal (Todd's) paresis, but a stroke must still be excluded
3. CCertainly a stroke, so the seizure can be ignored
4. DA sign that the patient is pretending to be weak

Which intervention most reduces pressure ulcer risk in an immobile patient?

1. AKeeping the head of the bed raised at 90° all day
2. BMassaging red areas firmly at each turn to bring back the circulation
3. CRegular repositioning and a pressure-redistributing mattress
4. DUsing a doughnut-shaped ring cushion

उच्च-ग्रेड लिम्फ़ोमा के लिए कीमोथेरेपी शुरू करने के दो दिन बाद मरीज़ का मूत्र उत्पादन घटता है; पोटैशियम 6.4 mmol/L, फ़ॉस्फ़ेट अधिक और कैल्शियम कम है। नर्स को क्या संदेह होना चाहिए और क्या करना चाहिए?

1. Aएलर्जी प्रतिक्रिया: एंटीहिस्टामिन देना और सामान्य रूप से जारी रखना
2. Bसाधारण निर्जलीकरण: मुँह से द्रव के लिए प्रोत्साहित करना और अगले सप्ताह रक्त जाँच दोहराना
3. Cअपेक्षित कीमोथेरेपी दुष्प्रभाव: अगले चक्र तक किसी कार्रवाई की आवश्यकता नहीं
4. Dट्यूमर लाइसिस सिंड्रोम: आगे सूचित करना, कार्डियक मॉनिटरिंग शुरू करना और IV द्रव की अपेक्षा रखना