NCLEX-शैली की प्राथमिकता निर्धारण और प्रत्यायोजन: क्रैम पैक

On the first day after abdominal surgery, a patient has a temperature of 37.9 °C and reduced breath sounds at the lung bases. Which nursing action is most helpful?

1. AEncourage deep breathing, coughing and use of the incentive spirometer
2. BKeep the patient lying flat in bed to rest the incision fully
3. CRestrict oral fluids so that the lungs do not fill up with extra fluid
4. DGive a cough suppressant so that the incision is not strained

A patient admitted with suspected appendicitis says the pain suddenly got better, but now the abdomen is rigid and the heart rate is rising. What does this suggest?

1. AThe patient’s analgesic has finally started to work
2. BThe pain has moved to a different, harmless place
3. CThe appendicitis is getting better without surgery
4. DThe appendix may have ruptured, causing peritonitis

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

1. A0.9% sodium chloride
2. B5% dextrose in 0.45% sodium chloride
3. C5% dextrose in water
4. DLactated Ringer’s (Hartmann’s) solution

A nurse sees a doctor about to insert a central line without a sterile gown, and a polite comment was ignored. Which TeamSTEPPS phrase helps to stop the procedure?

1. A“Let’s talk about it after you have finished.”
2. B“I will mention this to the manager at the next staff meeting.”
3. C“I am sure you know what you are doing.”
4. D“I am concerned, I am uncomfortable, this is a safety issue.”

प्रयोगशाला वार्ड को 6.9 mEq/L के गंभीर पोटैशियम परिणाम की सूचना फ़ोन पर देती है। नर्स को क्या करना चाहिए?

1. Aमान दर्ज करें और अगली शिफ़्ट को सौंप दें
2. Bमान दोहराकर पुष्टि करें, रोगी का आकलन करें और निर्धारक को सूचित करें
3. Cकिसी को बताने से पहले प्रयोगशाला से परीक्षण दोहराने को कहें
4. Dकोई भी कार्रवाई करने से पहले लिखित रिपोर्ट आने की प्रतीक्षा करें

A patient has macrocytic anemia with low vitamin B₁₂ and antibodies to intrinsic factor. What does this suggest, and how is it usually treated?

1. APernicious anemia, treated with B₁₂ injections
2. BFolate deficiency, treated with folic acid only
3. CHemolytic anemia, treated with blood transfusion
4. DIron deficiency, treated with oral iron tablets

Which technique is correct when suctioning through a tracheostomy?

1. AKeep suctioning for at least a minute each time to clear all the secretions
2. BApply suction continuously while inserting the catheter as far as it will go
3. CSuction every 15 minutes whether or not secretions are present
4. DApply suction only while withdrawing the catheter, for no more than about 10–15 seconds

एक नर्स को यक़ीन नहीं है कि उच्च-जोखिम दवा की निर्धारित ख़ुराक सही है। सबसे सुरक्षित कार्रवाई क्या है?

1. Aडॉक्टर उपलब्ध होने तक समझौते के रूप में आधी ख़ुराक दें
2. Bइसे रोकें और पहले निर्धारक या फ़ार्मासिस्ट से जाँच करें
3. Cख़ुराक दे दें क्योंकि डॉक्टर ने प्रिस्क्रिप्शन पर हस्ताक्षर किए हैं
4. Dमरीज़ से पूछें कि क्या ख़ुराक सामान्य जैसी दिखती है और दे दें

After coronary artery bypass surgery through a median sternotomy, which instruction is usually given for the first several weeks?

1. AAvoid heavy lifting and pushing up with the arms
2. BAvoid walking until the stitches are removed
3. CSleep only on the stomach to protect the wound
4. DLift the arms above the head often to stretch the chest

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. AAcute stent thrombosis
2. BIndigestion from the hospital meal
3. CPericarditis from the catheter
4. DNormal pain from the procedure site

A patient with type 1 diabetes plans a long cycle ride. Which advice is most appropriate?

1. AAvoid checking glucose until the ride is over
2. BCheck glucose before and after, and carry fast-acting carbohydrate
3. CTake an extra dose of rapid-acting insulin before setting off
4. DSkip breakfast so the exercise burns body fat

A patient with nephrotic syndrome suddenly has loin pain, blood in the urine and a rise in creatinine. What is a likely cause?

1. AToo much dietary protein
2. BRenal vein thrombosis
3. CNormal fluctuation in the disease
4. DA simple bladder infection

A patient is starting regular oral morphine. Which bowel advice is most appropriate?

1. AWait until there has been no stool for a week
2. BStop eating fibre completely
3. CStart a regular laxative at the same time
4. DTake a bulk-forming laxative only with very little water

परिधीय कैनुला से IV विन्क्रिस्टीन इन्फ़्यूज़न के दौरान मरीज़ जलन बताता है और जगह सूजी हुई है। नर्स को पहले क्या करना चाहिए?

1. Aकैनुला तुरंत निकालना और दवा फैलाने के लिए उस क्षेत्र की मालिश करना
2. Bइन्फ़्यूज़न धीमी गति से जारी रखना और उस जगह पर बर्फ़ की थैली लगाना
3. Cबची हुई दवा को नस में धकेलने के लिए कैनुला को सलाइन से फ़्लश करना
4. Dइन्फ़्यूज़न रोकना, कैनुला को एस्पिरेशन के लिए छोड़ना, नीति का पालन करना