NCLEX-शैली की प्राथमिकता निर्धारण और प्रत्यायोजन: क्रैम पैक

A nurse teaches a patient about sublingual nitroglycerin tablets. Which statement shows a need for further teaching?

1. A“I may get a headache after taking a tablet.”
2. B“I will keep the tablets in their original dark container.”
3. C“I will swallow the tablet with a glass of water.”
4. D“I will sit down before I take a tablet.”

After a head injury, a patient passes large amounts of very dilute urine, is thirsty and has a rising serum sodium. Which condition is most likely?

1. ADiabetes insipidus
2. BAcute kidney injury with oliguria
3. CSIADH
4. DDiabetic ketoacidosis

Why is blood glucose control important around the time of surgery?

1. ALow glucose is needed around surgery so that the wound edges close more quickly
2. BHigh glucose makes anesthetic drugs work for much longer and delays waking up
3. CGlucose levels only affect patients who have type 1 diabetes
4. DHigh glucose impairs white cell function and raises the risk of surgical site infection

Which position is especially dangerous for a patient in physical restraints?

1. ALying on the back with the head raised
2. BSitting upright in bed
3. CLying on the side
4. DLying face down (prone)

How does normal pregnancy usually affect serum creatinine?

1. AIt rises with every week
2. BIt falls, because GFR rises
3. CIt stays exactly the same
4. DIt rises, because GFR falls

A patient with acute kidney injury has a potassium of 6.8 mEq/L despite medical treatment, a pH of 7.12 and pulmonary edema not responding to diuretics. Which treatment is most likely needed?

1. AAn IV magnesium dose
2. BUrgent dialysis
3. CMore oral fluid
4. DA potassium supplement

Which statement about storing insulin is correct?

1. AInsulin never expires once opened
2. BAll insulin should be stored in the freezer to keep it fresh
3. CInsulin should be kept in direct sunlight
4. DUnopened insulin is kept in the fridge and must not be frozen

A patient with full mental capacity decides against a treatment that the team thinks is best. What does the Mental Capacity Act 2005 (England and Wales) say?

1. AThe family may make the decision instead if they disagree with the patient's choice
2. BThe patient must be assessed by a psychiatrist before refusing
3. CA person is not treated as lacking capacity just because they make an unwise decision
4. DThe team may override any decision that it disagrees with if it is serious

A pulse oximeter on a patient's finger gives an unreliable, flickering reading. Which factor is the most likely cause?

1. ACold hands with poor peripheral circulation
2. BA regular heart rate of 75 beats per minute
3. CThe patient sitting upright in a chair
4. DThe patient having eaten recently

A nurse teaches a patient with heart failure who takes ramipril and spironolactone. Which statement shows a need for further teaching?

1. A"I will weigh myself every morning after I go to the toilet."
2. B"I will avoid ibuprofen for my joint pain."
3. C"I will use a salt substitute instead of ordinary salt."
4. D"I will call if I gain weight quickly or get more breathless."

The day after a thyroidectomy, a patient reports tingling around the mouth and in the fingers. Why might this happen?

1. AThe parathyroid glands may have been damaged, lowering calcium
2. BThe thyroid hormone level has risen too high after surgery
3. CThe anaesthetic has caused an allergic reaction
4. DThe patient is breathing too slowly after the operation

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

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

Which statement correctly describes physical dependence on opioids?

1. AThe patient is allergic to opioids
2. BWithdrawal occurs if the drug is stopped suddenly
3. CThe drug no longer has any side effects
4. DThe patient always craves the drug and misuses it despite harm

Which medicine commonly needs enteral feeds paused before and after each dose because the feed reduces its absorption?

1. AParacetamol
2. BPhenytoin
3. CLactulose
4. DOmeprazole liquid