NCLEX-शैली की प्राथमिकता निर्धारण और प्रत्यायोजन: क्रैम पैक

On the first day after abdominal surgery, a patient has a temperature of 37.9 °C and reduced breath sounds at the lung bases. Which nursing action is most helpful?

1. AEncourage deep breathing, coughing and use of the incentive spirometer
2. BGive a cough suppressant so that the incision is not strained
3. CKeep the patient lying flat in bed to rest the incision fully
4. DRestrict oral fluids so that the lungs do not fill up with extra fluid

A medical-unit nurse is floated to intensive care and given a patient on a ventilator, which the nurse has never managed. What is the best response?

1. AAccept the full assignment without comment to avoid conflict
2. BTell the charge nurse about the gap, accept tasks within competence and ask for support
3. CLeave the intensive care unit and go back to the medical unit without telling anyone
4. DRefuse to work and go home, because the assignment is unsafe

Which measure reduces errors caused by interruptions during medication preparation?

1. AA quiet “no interruption” zone or signal while preparing medications
2. BPreparing medications at the busiest place on the ward
3. CPreparing medications for all patients at once
4. DAnswering phone calls and pages while counting tablets, to save time

In a mass-casualty incident with limited resources, why may a critically injured patient with little chance of survival receive care after others?

1. AThe most severely injured are never given comfort care
2. BCritical patients are always treated last in every situation, even outside disasters
3. CResources go first to those most likely to survive with treatment
4. DPatients are treated in the order they arrive

A tired patient with heavy menstrual periods has a normal hemoglobin and MCV but a ferritin of 8 ng/mL. What does this show?

1. AIron overload from too much iron
2. BIron deficiency without anemia yet
3. CVitamin B₁₂ deficiency anemia
4. DA completely normal iron status

A patient with a stable INR on warfarin starts rifampin (rifampicin) for tuberculosis. Two weeks later the INR is 1.3. What is the most likely explanation?

1. ARifampin contains a lot of vitamin K
2. BRifampin raises the INR, so it is wrong
3. CRifampin speeds up warfarin metabolism
4. DTuberculosis causes the INR to fall

A spontaneously breathing patient is critically ill and hypoxic. Which oxygen delivery gives the highest concentration?

1. ANasal cannula at 2 L/min
2. BSimple face mask at 5 L/min with the patient sitting up
3. CVenturi mask set to 24%
4. DNon-rebreathe mask with reservoir bag at 15 L/min

A patient has a swollen, warm, tender calf on one side. Which action should the nurse avoid?

1. AMassaging the calf
2. BMeasuring and comparing calf circumference
3. CChecking whether VTE prophylaxis was given
4. DReporting the findings to the doctor

What is the main problem in heart failure with preserved ejection fraction?

1. AA stiff ventricle that fills poorly in diastole
2. BA dilated ventricle that cannot contract strongly
3. CA blocked pulmonary artery
4. DA leaking aortic valve

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

A patient with a spinal cord injury can still feel a light touch around the anus. What does this show?

1. AThe injury is complete, and recovery is not possible
2. BThe sensation is only a spinal reflex and has no real meaning for recovery
3. CThe injury is incomplete, which suggests a better chance of recovery
4. DThe patient has an injury of the brain, not the cord

हीमोडायलिसिस के मरीज़ों के लिए दवा के समय का कौन-सा मुद्दा महत्वपूर्ण है?

1. Aडायलिसिस कोई दवा नहीं निकालता
2. Bसभी दवाएँ सत्र से ठीक पहले दी जानी चाहिए
3. Cडायलिसिस से निकलने वाली दवाएँ सत्र के बाद देनी पड़ सकती हैं
4. Dडायलिसिस के दिनों में कोई दवा नहीं ली जा सकती

Why is an ankle-brachial pressure index (ABPI) measured before compression bandaging for a leg ulcer?

1. ATo exclude significant arterial disease
2. BTo check for a leg bone fracture
3. CTo find the bacteria in the wound
4. DTo find out how deep the ulcer is

दीर्घकालिक गुर्दा रोग वाले 74 वर्षीय मरीज़ को सर्जरी के बाद तीव्र दर्द है। ओपिऑइड से जुड़ा कौन-सा मुद्दा सबसे महत्वपूर्ण है?

1. Aवृद्धों में दर्द चाहे जैसा हो, ओपिऑइड कभी उपयोग नहीं करने चाहिए
2. Bगुर्दा विफलता में मॉर्फ़ीन सबसे सुरक्षित ओपिऑइड है, इसलिए खुराक खुलकर बढ़ाई जा सकती है
3. Cमॉर्फ़ीन के मेटाबोलाइट जमा होते हैं, इसलिए कम खुराक या अन्य ओपिऑइड की आवश्यकता हो सकती है
4. Dगुर्दा कार्य का ओपिऑइड के संसाधन पर कोई प्रभाव नहीं पड़ता