NCLEX-शैली की प्राथमिकता निर्धारण और प्रत्यायोजन: क्रैम पैक

A patient’s chest tube becomes disconnected from the drainage system. What should the nurse do first?

1. APlace the end of the tube in a bottle of sterile water
2. BRemove the tube and cover the site
3. CWait for the provider to arrive before doing anything else
4. DClamp the tube for the rest of the shift

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

एक मरीज़ को छाती के एक हिस्से पर शिंगल्स (हर्पीज़ ज़ोस्टर) है, उसकी प्रतिरक्षा सामान्य है और घाव पूरी तरह ढके जा सकते हैं। आमतौर पर कौन-सी सावधानियाँ आवश्यक हैं?

1. Aघावों को ढककर मानक सावधानियाँ
2. Bकेवल बूँद सावधानियाँ
3. Cपॉज़िटिव प्रेशर वाला सुरक्षात्मक वातावरण
4. Dनेगेटिव-प्रेशर कमरे में वायुजनित सावधानियाँ

Patients contaminated with radioactive dust arrive at the hospital. Which step removes most of the external contamination?

1. AWrapping the patient in a blanket
2. BScrubbing the skin until it is red
3. CRemoving the patient’s clothing
4. DGiving the patient potassium iodide

कौन-सा ECG परिवर्तन हाइपोकैल्सीमिया से जुड़ा है?

1. Aछोटा हुआ QT अंतराल
2. Bऊँची, नुकीली T तरंगें
3. Cप्रमुख डेल्टा तरंग
4. Dलंबा हुआ QT अंतराल

A patient with a round face, central weight gain and purple stretch marks has a glucose of 210 mg/dL (11.7 mmol/L) and a potassium of 3.1 mEq/L. Which condition fits best?

1. ADiabetes insipidus
2. BHypothyroidism
3. CCushing syndrome
4. DAdrenal insufficiency

A patient is receiving enteral feeding through a nasogastric tube. How should they be positioned during feeding?

1. ALying on the left side with the head down to help the feed drain
2. BWith the head of the bed raised to at least 30 degrees
3. CLying completely flat
4. DIn any position, as long as the feed runs slowly

उच्च-प्रवाह ऑक्सीजन पर COPD वाला एक मरीज़ उनींदा हो जाता है, नाड़ी उछलती (bounding) है और त्वचा लाल है। ब्लड गैस में बढ़ा हुआ PaCO₂ और कम pH दिखता है। सबसे संभावित कारण क्या है?

1. Aउल्टी से मेटाबोलिक एल्कलोसिस
2. Bओपिऑइड एलर्जी
3. Cहाइपोग्लाइसीमिया
4. Dहाइपरकैप्निक श्वसन विफलता, आंशिक रूप से अत्यधिक ऑक्सीजन के कारण

A patient choosing between a mechanical and a biological heart valve asks about the main difference. Which answer is accurate?

1. ABiological valves last longer but need lifelong warfarin
2. BMechanical valves wear out within one year
3. CMechanical valves last longer but need lifelong anticoagulation
4. DBoth types need no medicines after surgery

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

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

An 80-year-old with angina is diagnosed with hypothyroidism. How is levothyroxine usually started?

1. AAs a single large weekly injection
2. BOnly after the angina has been cured
3. CAt a low dose, increased slowly
4. DAt a full dose from the first day

A patient with Guillain–Barré syndrome has a blood pressure that swings between 80/50 and 190/100 mmHg and a heart rate that changes suddenly. What does this suggest?

1. AAnxiety that will settle with reassurance alone
2. BA faulty blood pressure cuff that should be replaced and the readings ignored
3. CAutonomic dysfunction, which needs continuous cardiac monitoring
4. DA drug reaction that means all medicines must stop

After laparoscopic cholecystectomy, a patient has pain in the right shoulder. What is the most likely cause?

1. AGas used during surgery irritating the diaphragm
2. BA dislocated shoulder from patient positioning
3. CA heart attack during the operation
4. DAn allergy to the dressing on the wound

On the day after a Hartmann's procedure, the end colostomy is dark purple to black. What should the nurse do?

1. AReport it urgently, as the stoma may be necrotic
2. BCut a smaller hole in the pouch
3. CRub the stoma to improve its colour
4. DRecord it as normal postoperative bruising and recheck it next week