अन्तर्राष्ट्रिय नर्सिङ (NCLEX, DHA, HAAD)

अन्तर्राष्ट्रिय नर्सिङ: प्रश्न र उत्तर

सही लागेको विकल्पमा थिच्नुहोस्। सही भए हरियो, गलत भए रातो देखिन्छ; ३ सेकेन्डपछि सही उत्तर र व्याख्या देखिन्छ।

सही: ० / ०

801. When assessing a client with edema, the nurse observes pitting edema extending to the mid-calf. Which finding would MOST likely contribute to this condition?

     कThe client was recently diagnosed with hypertension. खThe client has been immobilized for 3 days following surgery. गThe client is receiving intravenous fluids at a rate of 150 mL/hour. घThe client reports taking a diuretic medication.
     💬 टिप्पणी / गल्ती रिपोर्ट (०)

     छलफल / प्रश्न उत्तरमा गल्ती छ

     पठाउनुहोस्

     टिप्पणी जाँचपछि मात्र देखिन्छ।

802. A patient presents to the clinic complaining of fever (38.5°C), chills and muscle aches. Which nursing action is MOST appropriate as a first response?

     कAdminister an over-the-counter antipyretic medication (e.g., acetaminophen) without further assessment. खAssess the patient's airway, breathing, and circulation (ABCs). गEncourage the patient to drink warm beverages and rest comfortably. घNotify the physician immediately, as this could be a serious infection.
     💬 टिप्पणी / गल्ती रिपोर्ट (०)

     छलफल / प्रश्न उत्तरमा गल्ती छ

     पठाउनुहोस्

     टिप्पणी जाँचपछि मात्र देखिन्छ।

803. A nurse is caring for a client who has recently undergone abdominal surgery. Which assessment finding would most immediately indicate a potential complication requiring intervention?

     कA) The client reports mild discomfort and nausea after meals. खB) Bowel sounds are normoactive in all four quadrants. गC) The client's surgical incision appears red, warm, and edematous with purulent drainage. घD) The client verbalizes understanding of post-operative dietary instructions.
     💬 टिप्पणी / गल्ती रिपोर्ट (०)

     छलफल / प्रश्न उत्तरमा गल्ती छ

     पठाउनुहोस्

     टिप्पणी जाँचपछि मात्र देखिन्छ।

804. A client has just undergone an esophagogastroduodenoscopy (EGD). Which nursing action is MOST important in assessing for potential complications immediately after the procedure?

     कAssess breath sounds. खMonitor urine output hourly. गApply ice packs to the injection site. घCheck gag reflex.
     💬 टिप्पणी / गल्ती रिपोर्ट (०)

     छलफल / प्रश्न उत्तरमा गल्ती छ

     पठाउनुहोस्

     टिप्पणी जाँचपछि मात्र देखिन्छ।

805. A nurse is caring for a patient with peritonitis secondary to bowel obstruction. The patient exhibits abdominal distension, nausea and vomiting, and an inability to pass gas. Which nursing intervention is MOST critical at this time?

     कAdminister antiemetic medication. खMaintain NPO status. गAssess the patient’s vital signs every 5 minutes. घEncourage frequent small sips of clear liquids.
     💬 टिप्पणी / गल्ती रिपोर्ट (०)

     छलफल / प्रश्न उत्तरमा गल्ती छ

     पठाउनुहोस्

     टिप्पणी जाँचपछि मात्र देखिन्छ।

806. A client recovering from a total hip arthroplasty reports pain rated as 8/10. The nurse assesses that the client's pain is associated with guarding, grimacing, and muscle tension. Which intervention is most appropriate to implement FIRST?

     कAdminister prescribed opioid analgesic. खEncourage the client to perform deep breathing exercises. गAssist the client in assuming a position of comfort and relaxation. घApply heat to the affected limb.
     💬 टिप्पणी / गल्ती रिपोर्ट (०)

     छलफल / प्रश्न उत्तरमा गल्ती छ

     पठाउनुहोस्

     टिप्पणी जाँचपछि मात्र देखिन्छ।

807. A patient with chronic heart failure presents with dyspnea and edema. The nurse knows that dietary restriction of sodium is a key component of management. Which intervention would the nurse implement FIRST?

     कAdminister oxygen at 2L/min via nasal cannula. खEncourage fluid intake to maintain hydration. गInstruct the client on a low-sodium diet (typically less than 2 grams per day). घMonitor blood pressure continuously.
     💬 टिप्पणी / गल्ती रिपोर्ट (०)

     छलफल / प्रश्न उत्तरमा गल्ती छ

     पठाउनुहोस्

     टिप्पणी जाँचपछि मात्र देखिन्छ।

808. During wound care for a client with a pressure ulcer on their sacrum, the nurse notices significant purulent drainage and odor. Which of the following actions is *most* appropriate?

     कContinue with gentle cleansing using warm water. खApply a topical antibiotic ointment to the affected area. गDocument the findings accurately and consult the physician immediately. घIncrease the frequency of dressing changes to promote healing.
     💬 टिप्पणी / गल्ती रिपोर्ट (०)

     छलफल / प्रश्न उत्तरमा गल्ती छ

     पठाउनुहोस्

     टिप्पणी जाँचपछि मात्र देखिन्छ।

809. A 68-year-old client with a history of type 2 diabetes presents to the emergency department complaining of sudden onset severe flank pain, nausea, vomiting, and fever. Initial assessment reveals a blood glucose level of 650 mg/dL and fruity breath odor. What is the *priority* nursing intervention?

     कAdminister sliding scale insulin. खInitiate intravenous fluids with dextrose. गPrepare the client for immediate admission to an intensive care unit. घMonitor urine output closely.
     💬 टिप्पणी / गल्ती रिपोर्ट (०)

     छलफल / प्रश्न उत्तरमा गल्ती छ

     पठाउनुहोस्

     टिप्पणी जाँचपछि मात्र देखिन्छ।

810. A patient with severe heart failure is experiencing shortness of breath and edema. Which of the following interventions would be *most* effective in reducing fluid overload?

     कAdministering a large oral dose of calcium gluconate. खEncouraging the client to increase their sodium intake. गElevating the head of the bed to at least 30 degrees. घApplying cool compresses to the dependent body parts.
     💬 टिप्पणी / गल्ती रिपोर्ट (०)

     छलफल / प्रश्न उत्तरमा गल्ती छ

     पठाउनुहोस्

     टिप्पणी जाँचपछि मात्र देखिन्छ।