NCLEX-शैली की प्राथमिकता निर्धारण और प्रत्यायोजन: क्रैम पैक

Using the Emergency Severity Index, which level fits a 70-year-old with chest pressure that suggests a heart attack, but normal vital signs?

1. ALevel 4
2. BLevel 5
3. CLevel 1
4. DLevel 2

Before surgery, a nurse is asked to witness a patient’s consent. The patient was given a sedative 30 minutes ago. What should the nurse do?

1. ANot witness the consent and inform the surgeon
2. BWitness it and write “sedated” beside the signature
3. CAsk a family member to sign on the patient’s behalf
4. DWitness it quickly before the sedative takes full effect

दवा की वायल और सिरिंज के साथ कौन-सी प्रथा सुरक्षित है?

1. Aवायल में हर बार प्रवेश करने पर नई स्टेराइल सुई और सिरिंज का उपयोग करना
2. Bनई सुई लगा दी जाए तो सिरिंज दोबारा उपयोग करना
3. Cएक ही सिरिंज को फ़्लश करके दो मरीज़ों के लिए उपयोग करना
4. Dबाद में उपयोग के लिए सुई को वायल के ढक्कन में लगा छोड़ देना

A nurse often skips barcode scanning to save time, as many colleagues do. In a just culture, how is this behavior classed?

1. AAt-risk behavior, managed by coaching and fixing the system pressures behind it
2. BReckless behavior, managed by immediate dismissal and reporting to the licensing board
3. CAcceptable behavior, because it is common on the unit
4. DSimple human error, managed only by consoling the nurse and moving on

A patient with a potassium of 2.8 mEq/L has potassium chloride prescribed IV. Which statement about giving it is correct?

1. AIt may be given as a slow IV push over one minute if the level is very low
2. BIt is always diluted and given by infusion pump, never as an IV push
3. CIt is given as an undiluted bolus into a large vein to avoid irritation
4. DIt is added to the IV bag without mixing, so it stays at the bottom

Four patients had a thyroidectomy earlier today. Which result should the nurse act on first?

1. AHemoglobin 12.1 g/dL (121 g/L) after surgery
2. BGlucose 145 mg/dL (8.0 mmol/L) after surgery
3. CSodium 136 mEq/L on IV fluids after surgery
4. DCalcium 7.2 mg/dL (1.8 mmol/L) with tingling lips

A patient is started on spironolactone while already taking an ACE inhibitor. Which blood result should be watched most closely?

1. AGlucose, because both drugs cause hyperglycaemia
2. BSodium, because both drugs raise it sharply
3. CCalcium, because both drugs lower it
4. DPotassium, because both drugs can raise it

A patient suddenly develops a severe "worst ever" headache that reached full intensity within seconds, followed by vomiting and neck stiffness. What should be suspected?

1. ASinusitis
2. BMigraine with aura in a known migraine sufferer
3. CSubarachnoid haemorrhage
4. DTension headache

A patient with heart failure takes furosemide once a day. When is the best time to take it?

1. AWhenever the ankles look swollen, on those days only
2. BAt bedtime, so the effect lasts through the night
3. CJust before the evening meal, with a large drink
4. DIn the morning, to avoid needing the toilet at night

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. APericarditis from the operation
2. BNormal wound healing with some expected discharge
3. CCostochondritis caused by forceful coughing
4. DSternal wound infection with an unstable sternum

A patient has taken metformin for many years and now has tingling feet and a low haemoglobin. Which blood test is most relevant?

1. AThyroid antibodies
2. BSerum amylase
3. CVitamin B12 level
4. DBlood alcohol level

A patient on warfarin starts levothyroxine for hypothyroidism. What should the nurse expect to monitor more closely?

1. AThe urine output, because it may stop
2. BThe INR, because it may rise
3. CThe potassium, because it may rise
4. DThe blood glucose, because it may fall

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

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

Two hours after a meal, a patient who had a gastrectomy becomes shaky, sweaty and confused. What is the most likely cause and first action?

1. ALate dumping with low blood glucose; check capillary glucose
2. BEarly dumping from fluid shifts; give a large drink of water
3. CVitamin B₁₂ deficiency; give an injection now
4. DAn anastomotic leak; insert a nasogastric tube at once