NCLEX-शैली की प्राथमिकता निर्धारण और प्रत्यायोजन: क्रैम पैक

A nurse gives IV morphine for severe pain. When should the nurse reassess the pain and sedation?

1. AAt the next routine round in four hours
2. BOnly when the patient asks for more
3. CAt the end of the shift
4. DWithin about 15–30 minutes

A provider asks a nurse to perform a procedure that is outside the nurse’s scope of practice. What should the nurse do?

1. ADecline, explain why and suggest who can safely do it
2. BDo it, because the provider gave the instruction
3. CAsk a nursing assistant to do it instead
4. DDo it just this once and promise the provider not to do it again

A patient walking with a gait belt suddenly starts to fall. What should the nurse do?

1. APull the patient backwards quickly toward the bed
2. BHold the belt, widen the stance and ease the patient gently to the floor
3. CGrab the patient under both arms and try hard to keep them standing up
4. DLet go of the belt and run to call for help

A patient rescued from a house fire has a headache and confusion, but the pulse oximeter reads 99%. Why might this reading be misleading?

1. APulse oximeters always read falsely low after any kind of smoke exposure
2. BConfusion and headache make pulse oximetry readings inaccurate in every patient
3. CThe reading is accurate, so carbon monoxide poisoning is ruled out
4. DPulse oximetry cannot tell carbon monoxide-bound hemoglobin from oxygen-bound hemoglobin

A patient's potassium is unexpectedly 5.8 mEq/L. The sample was taken after the tourniquet was on for several minutes while the patient pumped their fist. What is the best interpretation?

1. ATourniquet time affects only the glucose result, not the potassium
2. BThe result may be falsely high and should be repeated with better technique
3. CFist pumping lowers potassium, so the true level is even higher
4. DThe result confirms true hyperkalemia and needs no further checking

A patient has a continuous heparin infusion for a pulmonary embolism. A new nurse plans to adjust the infusion using today's INR of 1.1. What should the experienced nurse explain?

1. AHeparin is adjusted using the aPTT or anti-Xa level, not the INR
2. BThe INR of 1.1 means the heparin rate must be doubled at once
3. CThe INR is the correct test, and 1.1 means heparin is therapeutic
4. DHeparin needs no laboratory monitoring once the infusion is started

A patient with COPD and known carbon dioxide retention needs a nebulised bronchodilator. How should it usually be given?

1. ADriven by compressed air, with oxygen given separately if needed
2. BOnly with the patient lying flat
3. CWithout monitoring oxygen saturation
4. DDriven by high-flow oxygen at 15 L/min for as long as possible

A patient going home after chemotherapy is taught about infection. Which statement shows a need for further teaching?

1. A"I will check my temperature if I feel unwell or shivery at home."
2. B"If I get a temperature, I'll take paracetamol and wait until my next clinic."
3. C"I will wash my hands well before eating and after using the toilet."
4. D"I will phone the helpline if I have a fever or shivering."

A peripheral cannula site is red, warm, tender and swollen along the vein. What should the nurse do?

1. ALeave it in place, as this is normal after 24 hours
2. BCover the site and keep using it until it blocks
3. CFlush the cannula hard to clear it
4. DRemove the cannula, document and monitor the site

On the first day after abdominal surgery, a patient has a temperature of 37.8 °C, SpO₂ 93% on air and reduced breath sounds at both bases. They have stayed in bed because of pain. What is the most likely cause and response?

1. AAtelectasis: give analgesia, deep breathing and mobilisation
2. BNormal recovery; no action is needed
3. CWound infection: open the wound fully and swab it for culture
4. DPulmonary oedema: restrict all oral fluids and give a diuretic

A patient with type 1 diabetes has gastroenteritis and cannot eat. Which sick-day advice is correct?

1. ACheck glucose once a day only and rest in bed until better
2. BAvoid drinking fluids to reduce the vomiting
3. CStop all insulin until normal eating restarts
4. DKeep taking basal insulin and check glucose and ketones more often

टाइप 1 मधुमेह वाला मरीज़ कल की सर्जरी से पहले मुँह से कुछ नहीं ले रहा (NPO)। कौन-सी योजना सबसे सुरक्षित है?

1. Aमरीज़ के फिर सामान्य रूप से खाने-पीने तक सारा इंसुलिन बंद करना
2. Bइंसुलिन केवल तब देना जब रात में मूत्र कीटोन तेज़ी से पॉज़िटिव हो जाएँ
3. Cसामान्य भोजन-समय का इंसुलिन देना, भले ही कोई भोजन नहीं खाया जाएगा
4. Dग्लूकोज़ जाँच के साथ कुछ इंसुलिन (बेसल या परिवर्तनीय-दर IV इन्फ़्यूज़न) जारी रखना

Which burn should usually be discussed with a specialist burns service even if it is small?

1. AA partial-thickness burn on the hand
2. BA healed burn scar from many years ago
3. CA tiny burn on the forearm with redness only
4. DA small superficial sunburn on the back

A patient with a platelet count of 8 × 10⁹/L (8,000/µL) develops a sudden severe headache and confusion. What should the nurse suspect?

1. ANormal effects of chemotherapy
2. BA tension headache from stress
3. CDehydration from poor intake
4. DIntracranial bleeding