NCLEX-शैली की प्राथमिकता निर्धारण और प्रत्यायोजन: क्रैम पैक

An older adult asks for something to help them sleep. Which drug is most likely to cause confusion and falls in this age group?

1. AMelatonin
2. BDiphenhydramine
3. CA warm milky drink
4. DAcetaminophen (paracetamol)

At the end of a shift, the nurse’s relief has not arrived and the patients are acutely ill. What should the nurse do?

1. ALeave on time, because the shift has officially ended
2. BStay and tell the charge nurse, and hand over before leaving
3. CAsk a nursing assistant to watch the patients until someone comes
4. DLeave a written note at the station and go home

लेटेक्स एलर्जी वाले मरीज़ के लिए रोगी सुरक्षा का कौन-सा उपाय सबसे उपयुक्त है?

1. Aकेवल पाउडर वाले लेटेक्स दस्ताने पहनना
2. Bमरीज़ की देखभाल के दौरान सभी दस्तानों से बचना
3. Cलेटेक्स दस्ताने पहनना और बाद में हाथ अच्छी तरह धोना
4. Dलेटेक्स-मुक्त उपकरणों का उपयोग करना और एलर्जी को स्पष्ट रूप से दर्ज करना

A chemical cloud has been released near the hospital, and authorities order “shelter in place”. What should staff do?

1. ASend all visitors home through the main entrance
2. BEvacuate all patients into the car park at once
3. COpen the windows to let fresh air into the wards and dilute the chemical
4. DKeep everyone inside, close windows and doors and shut off outside air intake

A patient has macrocytic anemia with numbness and tingling of the feet and poor balance. Which deficiency is most likely?

1. AVitamin C (ascorbic acid)
2. BVitamin B₁₂
3. CFolate (folic acid)
4. DIron (low ferritin)

लंबे समय से फेफड़ों की बीमारी वाले रोगी का सीरम बाइकार्बोनेट 32 mEq/L, धमनी PaCO₂ हमेशा उच्च और pH 7.36 है। कौन-सी स्थिति सबसे उपयुक्त है?

1. Aदीर्घकालिक CO₂ प्रतिधारण और मेटाबॉलिक क्षतिपूर्ति के साथ COPD
2. Bगंभीर निर्जलीकरण और उल्टी के साथ तीव्र डायबिटिक कीटोएसिडोसिस
3. Cबाइकार्बोनेट की बड़ी हानि के साथ तीव्र गंभीर दस्त
4. Dतेज़ साँस के साथ तीव्र एस्पिरिन की अधिक मात्रा

A patient with renal colic is asked to pass urine through a strainer. Why?

1. ATo measure the urine's pH and specific gravity
2. BTo make passing urine less painful
3. CTo remove bacteria from the urine
4. DTo catch any stone so that it can be analysed

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. AIntrinsic kidney injury from glomerulonephritis, treated with high-dose steroids
2. BPre-renal acute kidney injury from poor perfusion, treated by restoring fluid volume
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

Why must inspired air be humidified for a patient with a tracheostomy?

1. AThe nose and upper airway, which warm and moisten air, are bypassed
2. BDry air is needed to stop secretions forming in the trachea
3. CHumidification prevents the cuff from deflating
4. DHumidified air contains more oxygen than dry air at the same flow

Ten days after cardiac surgery, a patient has a fever, a red sternal wound with discharge and a clicking feeling in the chest when coughing. What should the nurse suspect?

1. ANormal wound healing with some expected discharge
2. BCostochondritis caused by forceful coughing
3. CSternal wound infection with an unstable sternum
4. DPericarditis from the operation

A patient taking sodium valproate becomes tired and is vomiting, and the nurse notices yellowing of the eyes. What is the main concern?

1. AA sign that the dose is too low
2. BDehydration from drinking too little
3. CLiver toxicity from valproate
4. DA normal adjustment reaction to the drug

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

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

Why is it important to prevent perioperative hypothermia?

1. AIt reduces the amount of anaesthetic needed, which is unsafe
2. BIt lowers the risk of pain after surgery
3. CIt makes patients wake up from the anaesthetic too quickly
4. DIt increases bleeding, wound infection and heart complications

मरीज़ को नेगेटिव प्रेशर वाउंड थेरेपी दी जा रही है। पंप अलार्म बजाता है और ड्रेसिंग की सील खो गई है। सबसे उपयुक्त कार्रवाई क्या है?

1. Aसील पुनः बनाना; यदि समय पर यह विफल हो, तो नम ड्रेसिंग में बदलना
2. Bसमीक्षा तक कई दिनों के लिए फ़ोम को बिना सक्शन के घाव में छोड़ देना
3. Cफ़ोम के ऊपर घाव को सूखी गॉज़ से भरना और कसकर टेप लगाना
4. Dसील वापस खींचने के लिए सक्शन को अधिकतम सेटिंग पर करना