NCLEX-शैली की प्राथमिकता निर्धारण और प्रत्यायोजन: क्रैम पैक

On day 3 after hip surgery, a patient suddenly becomes short of breath with sharp chest pain and an SpO₂ of 88%. What should the nurse do first?

1. AMassage the patient’s calves to ease any muscle cramp
2. BRaise the head of the bed, give oxygen and call for urgent help
3. CGive the next dose of oral analgesia and reassess the patient in an hour
4. DEncourage the patient to walk to improve the circulation

A child with sickle cell disease in a pain crisis develops chest pain, fever and an SpO₂ of 89%. What does this most likely mean?

1. AAcute chest syndrome, which needs urgent escalation and oxygen
2. BAn ordinary pain crisis that will improve with rest
3. CA minor chest infection that can safely wait until the morning round
4. DAnxiety that will settle with reassurance

नई सुई लगाने पर भी इंसुलिन पेन एक से अधिक मरीज़ों के लिए कभी क्यों नहीं उपयोग करना चाहिए?

1. Aपेन साझा करने से दी जाने वाली खुराक बदल जाती है
2. Bरक्त वापस कार्ट्रिज में बह सकता है और संक्रमण फैला सकता है
3. Cसाझा करने पर पेन का इंसुलिन जल्दी समाप्त हो जाएगा
4. Dहर पेन में इंसुलिन की केवल एक खुराक होती है

एक यूनिट सांद्र पोटैशियम क्लोराइड की वायल वार्ड के स्टॉक अलमारी में रखती है। कई सुरक्षा दिशानिर्देश इसके विरुद्ध सलाह क्यों देते हैं?

1. Aपोटैशियम क्लोराइड की वायल खोलने के एक दिन के भीतर समाप्त हो जाती हैं
2. Bपोटैशियम क्लोराइड सामान्य वार्ड स्टॉक के रूप में रखने के लिए बहुत महँगा है
3. Cगलती से बिना तनु किया सांद्र घोल दिया जाए तो हृदय रुक सकता है
4. Dपोटैशियम क्लोराइड हमेशा मुँह से दिया जाना चाहिए

A patient without symptoms has a fasting plasma glucose of 132 mg/dL (7.3 mmol/L) on Monday and 138 mg/dL (7.7 mmol/L) on Thursday. What does this show?

1. AThe results are within the normal fasting range
2. BThe results meet the criteria for diabetes
3. CThe results show reactive hypoglycemia
4. DThe results show prediabetes only

A patient in DKA is receiving IV fluids and insulin. The glucose has fallen to about 220 mg/dL (12.2 mmol/L), but the anion gap is still high. What change would the nurse expect?

1. AGive an IV bolus of sodium bicarbonate at once
2. BStop the insulin infusion because the glucose is near normal
3. CStop the IV fluids and start oral fluids only
4. DAdd dextrose to the IV fluids and continue the insulin

A patient on peritoneal dialysis notices the drained fluid has become cloudy and has abdominal pain. What is likely?

1. APeritonitis
2. BConstipation
3. CNormal dialysis fluid
4. DA urinary tract infection

Four call bells ring at the same time. Which patient should the nurse see first?

1. AA patient who has just become breathless after starting an IV antibiotic
2. BA patient asking what time they will be discharged
3. CA patient who needs help to go to the toilet and has rung twice
4. DA patient asking for pain relief for chronic back pain that they rate as 3/10

How should a patient with asthma record their peak flow at home?

1. ATake the average of ten blows after exercise
2. BBlow only during an asthma attack, never when well
3. CTake the best of three blows, ideally morning and evening
4. DTake one gentle blow once a week, at any time of day

A patient being treated for infective endocarditis of the mitral valve suddenly develops slurred speech and weakness of the right arm. What is the most likely cause?

1. AA migraine aura triggered by the fever
2. BA side effect of the IV antibiotic on the nerves
3. CAn embolus from a valve vegetation causing a stroke
4. DLow blood glucose from a reduced appetite

Which picture fits anterior cord syndrome?

1. ANormal movement but complete loss of position sense
2. BLoss of movement and pain sense, with position sense kept
3. CArms much weaker than legs after a neck injury
4. DWeakness on one side and loss of pain sensation on the other side

A nurse teaches the family of a patient on insulin how to manage a severe hypo. Which statement shows a need for further teaching?

1. A"If she is unconscious, I will pour juice into her mouth."
2. B"I will put her on her side and call an ambulance straight away."
3. C"When she can swallow, I will give her a snack."
4. D"I will give the glucagon as I was shown."

Why are patients with diabetes often placed early on the operating list?

1. ABecause their surgery always takes longer than others
2. BBecause they need to go home before midday
3. CBecause their wounds heal faster in the morning
4. DTo shorten fasting and reduce swings in blood glucose

A patient has sharp, tearing pain on passing stool, "like passing glass", with a streak of fresh blood. Which condition is most likely?

1. AAnal fissure
2. BUpper GI bleeding
3. CCrohn's disease of the ileum
4. DColorectal cancer