NCLEX-शैली की प्राथमिकता निर्धारण और प्रत्यायोजन: क्रैम पैक

A nurse sees a nursing assistant leave a confused patient’s bed in the highest position after care. What should the nurse do?

1. ALower the bed now and remind the assistant why it matters
2. BAsk the family to lower the bed when they next visit
3. CLeave it because the patient is asleep
4. DWrite it in the assistant’s yearly review only

A patient at 36 weeks of pregnancy has sudden severe abdominal pain, a hard, board-like uterus and dark vaginal bleeding. What should the nurse suspect?

1. APlacental abruption, which is an emergency
2. BA urinary tract infection
3. CNormal labor contractions starting
4. DPlacenta previa, which is usually painless

How should a portable oxygen cylinder be kept in a patient’s room?

1. APlaced next to a heater to keep it warm
2. BLaid on the bed next to the patient
3. CSecured upright in a stand or holder
4. DLying loose on the floor beside the bed

एक मरीज़ तीव्र दस्त के साथ भर्ती होता है, और C. difficile का संदेह है। जाँच का परिणाम लंबित है। संपर्क सावधानियाँ कब शुरू होनी चाहिए?

1. Aतुरंत, जाँच परिणाम की प्रतीक्षा किए बिना
2. Bकेवल जब जाँच का परिणाम पॉज़िटिव आए
3. Cतीन दिन के दस्त के बाद
4. Dकेवल यदि मरीज़ को बुखार हो जाए

Why must a blue-top (citrate) coagulation tube be filled to the correct level?

1. AThe blood-to-anticoagulant ratio must be right for accurate clotting times
2. BUnderfilled tubes always give a falsely low hemoglobin and hematocrit
3. CAn overfull tube is needed to measure the potassium level
4. DThe laboratory charges extra when a tube is not filled correctly

A patient has a sodium of 150 mEq/L, a glucose of 180 mg/dL and a BUN of 28 mg/dL. Using the formula 2 × Na + glucose/18 + BUN/2.8, what is the calculated serum osmolality?

1. AAbout 285 mOsm/kg, which is normal
2. BAbout 300 mOsm/kg, which is normal
3. CAbout 358 mOsm/kg, which is high
4. DAbout 320 mOsm/kg, which is high

A nurse suspects that an older patient is being financially abused by a relative. What should the nurse do?

1. AKeep it secret because it is a family matter
2. BWait until the patient has been discharged
3. CConfront the relative directly at the bedside about it
4. DRaise the concern through the local safeguarding (adult protection) procedure

A patient with several days of vomiting and diarrhoea has low blood pressure, low urine output and a rising creatinine. Which description fits best?

1. APre-renal acute kidney injury from poor perfusion, treated by restoring fluid volume
2. BIntrinsic kidney injury from glomerulonephritis, treated with high-dose steroids
3. CChronic kidney disease, treated with long-term dialysis three times a week
4. DPost-renal acute kidney injury from obstruction, treated with a catheter

A patient with a long QT interval develops a polymorphic ventricular tachycardia that twists around the baseline but still has a pulse. Which drug is used first?

1. AOral digoxin
2. BIntravenous potassium chloride as a bolus
3. CIntravenous magnesium sulfate
4. DIntravenous adenosine

During CPR on an adult, a nurse notices a colleague compressing at about 140/min and leaning on the chest between compressions. Which correction is most appropriate?

1. ASlow to 100–120/min and allow full chest recoil
2. BPress more gently, to a depth of about 2 cm
3. CStop compressions until a pulse is felt
4. DSpeed up to about 160/min to improve the blood flow

During continuous bladder irrigation, 3200 mL drains out in a shift. 2500 mL of irrigation fluid was put in. What is the true urine output?

1. A2500 mL
2. B3200 mL
3. C700 mL
4. D5700 mL

A man who takes tamsulosin for BPH is listed for cataract surgery. Which statement is correct?

1. AThe dose should be doubled before surgery to prevent urinary retention
2. BTamsulosin has no effects outside the urinary tract, so nothing changes
3. CThe eye surgeon must be told, as it can cause floppy iris during surgery
4. DIt should be swapped for oxybutynin the night before to protect the eye

उच्च जोखिम वाले मरीज़ों में ट्यूमर लाइसिस सिंड्रोम रोकने में कौन-से उपाय मदद करते हैं?

1. Aरोज़ कैल्शियम और फ़ॉस्फ़ेट पूरक
2. Bपोटैशियम की गोलियों के साथ द्रव प्रतिबंध
3. Cकीमोथेरेपी के दौरान सभी IV और मौखिक द्रव बंद करना
4. Dएलोप्यूरिनॉल या रैस्ब्यूरिकेज़ के साथ IV जलयोजन

A patient on warfarin has a major upper GI bleed with an INR of 5. Which treatment should the nurse anticipate to reverse the warfarin?

1. AOral aspirin to balance the clotting system quickly
2. BMore warfarin to stabilise the INR
3. CProthrombin complex concentrate with IV vitamin K
4. DProtamine sulfate on its own