NCLEX-शैली की प्राथमिकता निर्धारण और प्रत्यायोजन: क्रैम पैक

A patient’s urinary catheter has drained no urine for two hours, and the lower abdomen is swollen. What should the nurse do first?

1. AEncourage the patient to drink more water
2. BCheck the tubing for kinks or obstruction
3. CRemove the catheter and wait for the patient to void
4. DGive a prescribed diuretic straight away

A nurse teaches a patient to inject enoxaparin at home. Which statement shows a need for further teaching?

1. A“I will change the injection site each time.”
2. B“I will inject into the fat of my abdomen, away from the navel.”
3. C“I will rub the area after the injection to help it absorb.”
4. D“I will tell my doctor if I notice unusual bruising or bleeding.”

An alcohol-based skin prep has been used before surgery with electrosurgery. What must happen before the drapes are placed?

1. AThe prep must be wiped off with saline
2. BThe prep must be warmed with a hair dryer
3. CThe prep must be fully dry and any pooled liquid removed
4. DThe prep must be covered with the drapes while it is still wet

A nurse calculates a child’s prescribed dose and finds it is ten times higher than the usual dose for the child’s weight. What should the nurse do?

1. AHold the dose and verify it with the prescriber and pharmacist
2. BGive half the dose and watch the child closely
3. CGive one-tenth of the dose without telling anyone about it
4. DGive it, because the prescriber must have a reason

Why must vitamin B₁₂ deficiency be ruled out before treating macrocytic anemia with folic acid alone?

1. AFolic acid can fix the anemia while B₁₂-related nerve damage continues
2. BFolic acid causes iron overload when B₁₂ levels are low
3. CFolic acid makes B₁₂ deficiency anemia much worse within a few days
4. DFolic acid blocks the absorption of all B₁₂ from the diet

कम मांसपेशी द्रव्यमान वाले दुर्बल वृद्ध व्यक्ति में सामान्य क्रिएटिनिन भ्रामक क्यों हो सकता है?

1. Aकम मांसपेशी कम क्रिएटिनिन बनाती है, जिससे घटा गुर्दा कार्य छिप जाता है
2. Bक्रिएटिनिन स्तर मांसपेशी द्रव्यमान पर बिल्कुल निर्भर नहीं करते
3. Cवृद्धों में क्रिएटिनिन हमेशा युवाओं से अधिक होता है
4. Dसामान्य क्रिएटिनिन हमेशा सामान्य गुर्दा कार्य सिद्ध करता है

WHO दर्दनिवारक सीढ़ी (analgesic ladder) क्या सुझाती है?

1. Aदर्द बढ़ने पर गैर-ओपिऑइड से कमज़ोर और फिर तेज़ ओपिऑइड की ओर बढ़ना
2. Bसभी मरीज़ों को तेज़ ओपिऑइड से शुरू करना
3. Cकैंसर दर्द के लिए केवल गैर-औषधीय विधियों का उपयोग
4. Dकेवल दर्द गंभीर होने पर दर्दनिवारक देना

A patient with severe ulcerative colitis develops abdominal distension, fever and tachycardia, and the number of stools falls. What complication should be suspected?

1. ACoeliac disease
2. BRecovery from the colitis
3. CConstipation from dehydration
4. DToxic megacolon

Rheumatic heart disease most often follows which infection?

1. AA viral infection of the upper airway
2. BA group A streptococcal throat infection
3. CA fungal infection of the lungs
4. DStaphylococcal infection of the skin

मायोकार्डियल इन्फार्क्शन के तीन सप्ताह बाद मरीज़ को बुखार, साँस लेने पर सीने का दर्द जो आगे झुकने पर कम होता है, और पेरिकार्डियल फ़्रिक्शन रब है। कौन-सी स्थिति सबसे संभावित है?

1. Aतीव्र बाएँ निलय की विफलता
2. Bतीव्र महाधमनी विच्छेदन
3. Cपोस्ट-MI (ड्रेस्लर) सिंड्रोम
4. Dकिसी अन्य धमनी में नया STEMI

A patient taking warfarin is diagnosed with an intracerebral haemorrhage. What is the priority treatment?

1. AUrgent reversal of the anticoagulant effect
2. BStarting aspirin to prevent further clots
3. CDoubling the warfarin dose to stabilise the INR
4. DIV thrombolysis within 4.5 hours

A patient with motor neurone disease reports morning headaches, poor sleep and sleepiness during the day. What do these symptoms suggest?

1. ANormal tiredness that needs no specific action
2. BA side effect of riluzole, which should be stopped straight away by the nurse
3. CLow mood, which should be treated with an antidepressant first
4. DWeak breathing at night, so a review for ventilation support

Which early symptoms suggest local anaesthetic systemic toxicity?

1. AMild itching of the feet the next day
2. BIncreased hunger and thirst over several hours, with a dry mouth
3. CTingling around the mouth, a metallic taste and tinnitus
4. DA red rash only at the injection site, with no other symptoms

After several days of a tight CPAP mask, a patient has a red, broken area on the bridge of the nose. What is this, and what should the nurse do?

1. AA normal mark; take no action until it heals
2. BAn allergic rash; stop the CPAP for good and give oral antihistamines
3. CA burn from the oxygen; apply ice to the area
4. DA device-related pressure injury; protect skin and refit the mask