NCLEX-शैली की प्राथमिकता निर्धारण और प्रत्यायोजन: क्रैम पैक

A patient uses patient-controlled analgesia (PCA) after surgery. Which statement by a family member shows a need for further teaching?

1. A“The pump has limits set by the nurse so she cannot get too much at once.”
2. B“I will tell the nurse if she becomes very sleepy or hard to wake.”
3. C“Only she should press the button when she needs pain relief.”
4. D“I will press the button for her while she is asleep so she stays comfortable.”

A 2-month-old infant has a spiral fracture of the femur. The parents say the baby rolled off the sofa. What should the nurse recognize?

1. AA spiral fracture in an infant is always caused by birth trauma
2. BInfants of this age often roll off furniture and break bones in this way
3. CNo further action is needed once the fracture is treated
4. DThe injury does not fit the infant’s development, so possible abuse must be reported

गोली देने से पहले मरीज़ कहता है, “यह गोली मेरी सामान्य गोली से अलग दिख रही है।” नर्स को क्या करना चाहिए?

1. Aआधी गोली देकर किसी असामान्य प्रभाव पर नज़र रखना
2. Bमरीज़ से कहना कि अस्पताल में सभी गोलियाँ अलग दिखती हैं
3. Cमरीज़ को आश्वस्त करके गोली दे देना
4. Dरुककर देने से पहले आदेश और दवा की दोबारा जाँच करना

A patient has a rash, and both smallpox and chickenpox are considered. Which finding suggests smallpox?

1. ALesions at different stages, most dense on the trunk
2. BSmall crops of new lesions appearing over several days in a row
3. CA rash that is very itchy and starts on the trunk
4. DLesions all at the same stage, most dense on the face and limbs

A patient starts high-dose prednisone. Which laboratory change should the nurse expect?

1. AA fall in serum sodium
2. BA rise in blood glucose
3. CA fall in the white cell count
4. DA rise in serum potassium

डायबिटिक कीटोएसिडोसिस वाले रोगी का इंसुलिन इन्फ़्यूज़न शुरू करने से पहले पोटैशियम 3.0 mEq/L है। नर्स को क्या अपेक्षित रखना चाहिए?

1. Aपोटैशियम सामान्य होने तक द्रव रोक दिए जाते हैं
2. Bपहले पोटैशियम बदला जाता है, और प्रोटोकॉल के अनुसार स्तर सुरक्षित होने तक इंसुलिन प्रतीक्षा करता है
3. Cइंसुलिन तुरंत उच्च दर पर शुरू किया जाता है
4. Dपोटैशियम नहीं बदला जाता, क्योंकि इंसुलिन उसे बढ़ाएगा

Which ECG change is typical of hypokalaemia?

1. AFlattened T waves and prominent U waves
2. BTall, peaked T waves
3. CA very short PR interval with a delta wave
4. DST elevation in leads II, III and aVF

A patient with suspected appendicitis says the pain suddenly eased, but an hour later has pain all over the abdomen, a rigid abdomen and a fever. What is most likely?

1. AThe patient has developed gastroenteritis
2. BThe analgesia has started working
3. CThe appendix has perforated, causing peritonitis
4. DThe appendicitis has resolved without treatment

दवा वर्गों का कौन-सा संयोजन घटी हुई इजेक्शन फ़्रैक्शन वाली हृदय विफलता में जीवित रहने की अवधि सुधारता है?

1. Aकेवल लूप डाइयूरेटिक, सहन की जा सकने वाली अधिकतम खुराक पर
2. BACE इनहिबिटर या ARNI, बीटा-ब्लॉकर, MRA और SGLT2 इनहिबिटर
3. CNSAID, एस्पिरिन, स्टैटिन और थायज़ाइड डाइयूरेटिक
4. Dलूप डाइयूरेटिक, डिगॉक्सिन, नाइट्रेट और कैल्शियम चैनल ब्लॉकर

A nurse teaches a patient who is starting warfarin. Which statement shows a need for further teaching?

1. A"If I miss a dose, I will take two the next day."
2. B"I will tell my dentist that I take warfarin."
3. C"I will check before taking any new medicines or herbal remedies."
4. D"I will have regular INR blood tests."

Why may a person with long-standing diabetes have a heart attack without typical chest pain?

1. ANerve damage can blunt the pain signals
2. BInsulin acts as a strong painkiller
3. CPeople with diabetes do not have heart attacks
4. DHigh glucose protects the heart from pain

The day after a lumbar puncture, a patient has a headache that is severe when standing and almost gone when lying flat. Temperature and neck movement are normal. What is the most likely cause?

1. ABacterial meningitis from the procedure
2. BPost-dural puncture headache
3. CA subarachnoid haemorrhage
4. DA migraine triggered by stress

Why are antimotility drugs such as loperamide avoided in C. difficile infection?

1. AThey cause serious liver failure in most patients who take them
2. BThey may keep toxin in the bowel and risk toxic megacolon
3. CThey kill the normal bowel bacteria
4. DThey make the stool sample test positive falsely

On day 5 after hip surgery, a patient suddenly becomes breathless, with sharp chest pain on breathing in, a pulse of 120/min and SpO₂ 89%. What should the nurse suspect and do first?

1. AAnxiety; give reassurance and repeat the observations in an hour's time
2. BSimple atelectasis; encourage walking around the ward
3. CPulmonary embolism; sit up, give oxygen and call for urgent help
4. DWound infection; take a wound swab and wait for results