अन्तर्राष्ट्रिय नर्सिङ लाइसेन्स NCLEX-RN, DHA, HAAD र CBT तयारी
अन्तर्राष्ट्रिय नर्सिङ लाइसेन्स – NCLEX-RN, DHA, HAAD र CBT
NCLEX-RN / DHA / HAAD · NCLEX-RN / DHA / HAAD / CBT
२,०४४ प्रश्न उपलब्ध। मोड छान्नुहोस्:
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
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Which of the following is the BEST location to auscultate the apical pulse in an adult client? a) Brachial artery. b) Femoral artery. c) Radial artery. d) Popliteal artery
सही उत्तर: ग) c
Option C is correct. The apex of the heart (apical pulse) is typically best heard over the radial artery in the wrist, as this position allows for optimal transmission of sound waves to the stethoscope. The other arteries are not ideal locations for apical pulse auscultation.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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A nurse is assessing a newly admitted patient who is experiencing shortness of breath. The patient’s respiratory rate is 32 breaths per minute, and they are using accessory muscles to assist with breathing. Which nursing intervention is MOST appropriate at this time? a) Encourage the patient to cough forcefully. b) Administer oxygen via nasal cannula at 2 liters per minute. c) Assess the patient's pain level and administer an analgesic. d) Elevate the head of the bed to promote lung expansion.
सही उत्तर: ख) b
Option B is correct because administering supplemental oxygen at a controlled flow rate (2 liters/minute) directly addresses the patient's respiratory distress. The other options are less immediately relevant: forceful coughing could exacerbate dyspnea, pain management might be needed later, and elevating the bed alone won’t address the rapid breathing.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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A 72-year-old client who underwent a surgical resection of the colon develops severe diarrhea and dehydration following antibiotic administration. The nurse suspects Clostridium difficile infection (CDI). What is the MOST appropriate initial nursing intervention?
सही उत्तर: ख) b) Initiating fluid replacement therapy and monitoring electrolyte balance
Initiating fluid replacement (option b) is paramount in managing dehydration. Monitoring electrolytes is crucial. While antibiotics might be necessary later, immediate hydration addresses the primary problem. Topical antiseptics and isolation are secondary measures.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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A client with newly diagnosed heart failure presents with shortness of breath and peripheral edema. The nurse is educating the client about dietary modifications. Which of the following instructions is MOST important for the nurse to include?
सही उत्तर: ख) b) Limit fluid intake to 1-2 liters per day
Limiting fluid intake (option b) is a cornerstone of managing heart failure. Sodium increases fluid retention, potassium imbalances can occur with diuretics, and increased protein isn't typically beneficial in this context.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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A client with chronic obstructive pulmonary disease (COPD) reports difficulty breathing and uses a peak flow meter regularly. The peak flow reading is consistently lower than usual. Which intervention should the nurse prioritize?
सही उत्तर: ख) b) Teaching pursed-lip breathing to enhance airflow
Pursed-lip breathing (option b) is a proven technique for COPD patients that helps control airway pressure and improve exhalation. Prescribing higher doses of bronchodilators without assessment could be harmful. Increasing activity would worsen symptoms, and restricting fluids wouldn't address the underlying airflow obstruction.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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A 68-year-old male client is recovering from a total knee replacement (TKR). He reports significant pain and stiffness in his affected leg, particularly after periods of inactivity. Which intervention is MOST appropriate for the nurse to implement at this time?
सही उत्तर: ख) b) Encouraging frequent range-of-motion exercises and passive assisted stretches
Encouraging frequent range of motion exercises (option b) is crucial in post-TKR recovery to prevent stiffness and improve mobility. While pain management is necessary, immediate opioid administration isn't always indicated. Ice packs are for acute inflammation; elevation alone doesn’t address the underlying stiffness.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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A client presents to the emergency department with severe abdominal pain, nausea, and vomiting. Laboratory results reveal elevated lipase and amylase levels. Which of the following is the MOST likely diagnosis?
सही उत्तर: ग) c) Acute Pancreatitis
Acute pancreatitis (option c) is characterized by elevated pancreatic enzymes (lipase and amylase) due to inflammation of the pancreas. The other options are less likely given the presented symptoms and laboratory findings. Diabetic Ketoacidosis typically presents with dehydration and altered mental status. Appendicitis would present with localized abdominal tenderness in the right lower quadrant.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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A client with pneumonia is coughing frequently and has a productive cough. Which nursing intervention is MOST appropriate to assist the client?
सही उत्तर: ख) Encouraging the client to take deep breaths only when they feel short of breath
Sitting upright facilitates easier coughing and drainage of secretions. Deep breaths only when needed prevents unnecessary effort and potential discomfort.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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A nurse is preparing to administer intravenous fluids to a client with heart failure. Which assessment finding should the nurse MOST closely monitor during fluid administration?
सही उत्तर: घ) Client’s urine output volume
Monitoring urine output is crucial in clients with heart failure, as it reflects fluid balance and renal function. Changes in this metric can quickly indicate excessive fluid administration or worsening of cardiac status.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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A nurse is assessing a newly admitted patient who has been complaining of generalized weakness and fatigue. Which assessment finding would be MOST important for the nurse to report to the physician immediately?
सही उत्तर: क) Blood pressure 90/60 mmHg
Low blood pressure (hypotension) is a critical sign of potential shock or other serious underlying conditions, requiring immediate medical attention. The other options are less immediately concerning as they don’t represent a life-threatening physiological instability.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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