NCLEX-शैली की प्राथमिकता निर्धारण और प्रत्यायोजन: क्रैम पैक

Which finding is an early sign of compartment syndrome in a patient with a lower leg fracture?

1. AMild bruising around the fracture site on the second day
2. BPain out of proportion to the injury that worsens when the toes are stretched
3. CA strong pedal pulse with warm, pink toes and pain that settles with analgesia
4. DItching under the cast during the first week after it was applied

A patient receiving comfort-focused end-of-life care is distressed by breathlessness. Which approach is most appropriate?

1. AGive prescribed opioids and use positioning and a fan to relieve breathlessness
2. BStart a series of aggressive tests to find the exact cause of the breathlessness
3. CLeave the patient alone so they can rest
4. DWithhold all opioids because they may slow breathing

A newly hired nurse had BCG vaccine as a child. Which TB screening test is usually preferred?

1. AA tuberculin skin test, which is read 24 hours after it is placed
2. BAn interferon-gamma release assay (IGRA) blood test
3. CNo screening, because BCG prevents all TB
4. DA chest x-ray every month for the first year

During bedside handoff, the patient says, “I’m allergic to sulfa drugs,” but no allergy is recorded. What should the nurse do?

1. AClarify the reaction, update the allergy record and tell the prescriber
2. BWait until the patient is discharged to update the record
3. CTell the patient that sulfa drugs are always safe
4. DIgnore it, because the electronic record is more reliable than the patient’s memory

How should a patient collect a clean-catch midstream urine sample?

1. AFill the cup completely, then add tap water if there is not enough
2. BClean the area, start voiding into the toilet, then catch the middle part
3. CCollect urine from the toilet bowl after voiding into the toilet
4. DCollect the very first urine of the stream directly in the sterile cup

शराब उपयोग विकार वाले रोगी का दो दिन के प्रतिस्थापन के बावजूद पोटैशियम 3.0 mEq/L है। मैग्नीशियम 0.9 mEq/L है। सबसे उपयुक्त अगला कदम क्या है?

1. Aसभी इलेक्ट्रोलाइट प्रतिस्थापन 24 घंटे के लिए रोक दें और दोबारा जाँचें
2. Bमैग्नीशियम बदलें; कम मैग्नीशियम गुर्दों से पोटैशियम की हानि जारी रखता है
3. Cपोटैशियम की खुराक दोगुनी करें और मैग्नीशियम बाद के लिए छोड़ दें
4. Dअतिरिक्त मैग्नीशियम निकालने के लिए मूत्रवर्धक दें

IV इन्फ़्यूज़न के दौरान कैनुला के आसपास का क्षेत्र सूजा, ठंडा और पीला हो जाता है, और इन्फ़्यूज़न धीमा हो जाता है। क्या संभावित है?

1. Aआसपास के ऊतक में द्रव का अंतःस्यंदन (infiltration)
2. Bनस की दीवार के जीवाणु संक्रमण से फ़्लेबाइटिस
3. Cपरिसंचरण में द्रव अधिभार
4. Dवायु एम्बोलिज़्म

A patient rescued from a house fire has soot around the mouth, singed nasal hairs and a hoarse voice. What is the main concern?

1. AA minor throat infection
2. BHypothermia from the fire service water
3. CDehydration from sweating
4. DAirway swelling from inhalation injury

How big should a suction catheter be compared with the tracheostomy or endotracheal tube?

1. AAny size, as the diameter does not matter
2. BLarger than the tube, so that it clears it completely
3. CExactly the same diameter as the tube, for a tight fit
4. DNo more than half the internal diameter of the tube

समुदाय-अर्जित निमोनिया वाले 82 वर्षीय मरीज़ को नया भ्रम, RR 32/min, BP 88/52 mmHg और यूरिया 9 mmol/L है। यह क्या दर्शाता है?

1. Aबुज़ुर्ग में संक्रमण की सामान्य प्रतिक्रिया
2. BCURB-65 स्कोर 1: घर पर मौखिक एंटीबायोटिक के लिए उपयुक्त
3. CCURB-65 स्कोर 3: केवल सामान्य वार्ड में नियमित भर्ती
4. DCURB-65 स्कोर 5: उच्च जोखिम जिसमें तत्काल वरिष्ठ समीक्षा चाहिए

A patient with advanced CKD asks how to manage indigestion. Which option should they avoid?

1. AEating smaller, more frequent meals
2. BAvoiding large meals late in the evening
3. CRaising the head of the bed at night
4. DMagnesium-containing antacids

CKD वाले मरीज़ का हीमोग्लोबिन 92 g/L है और वह एरिथ्रोपोइसिस-उत्तेजक एजेंट (ESA) शुरू करता है। नर्स को किसकी निगरानी करनी चाहिए?

1. Aरक्त ग्लूकोज़, क्योंकि ESA अक्सर हाइपोग्लाइसीमिया करते हैं
2. Bरक्तचाप और हीमोग्लोबिन, क्योंकि अधिक बढ़ने से थक्के का जोखिम बढ़ता है
3. Cसुनने की क्षमता, क्योंकि ESA भीतरी कान को नुकसान पहुँचा सकते हैं
4. Dयकृत एंज़ाइम, क्योंकि ESA यकृत के लिए विषाक्त हैं

Which patient is at highest risk of refeeding syndrome?

1. AAn underweight patient who has eaten very little for 10 days
2. BA patient with a normal BMI eating three meals a day
3. CA healthy adult after an overnight fast for minor surgery
4. DA patient who missed one lunch because of a scan

During radiotherapy to the chest, a patient develops pain on swallowing and is eating less. What is the most likely cause and nursing focus?

1. AA stomach ulcer; give an antacid after meals only
2. BNormal ageing; no action needed
3. CRadiation oesophagitis; analgesia, soft food and nutrition support
4. DA heart attack; give aspirin and arrange an ECG