Domande di pratica in stile NCLEX-PN (LPN/LVN): pacchetto last-minute

What is medicines reconciliation on admission?

1. AGetting an accurate list of the medicines taken before admission
2. BCounting the tablets in the ward drug trolley at the start of each shift
3. COrdering new stock from the pharmacy
4. DChanging all the patient's medicines to hospital brands

Why is the level of sedation a useful early warning in a patient on opioids?

1. AIncreasing sedation usually comes before respiratory depression
2. BSedation means the opioid dose is too low
3. CSedation shows that the pain has completely gone and the dose is right
4. DSedation only occurs after the breathing has stopped

A family member will visit a patient on contact precautions. What should the nurse do?

1. AShow them how to use the gown and gloves and how to clean their hands
2. BTell them visits are not allowed at all
3. CTell them precautions only apply to staff
4. DAsk them to wear an N95 respirator only, with no gown or gloves

A nurse teaches a patient about home oxygen safety. Which statement shows a need for further teaching?

1. A“I can light candles at dinner if my oxygen is turned down low.”
2. B“I will keep my oxygen away from the stove.”
3. C“I will keep my spare cylinders upright and secured.”
4. D“I will put a ‘no smoking’ sign on my front door for visitors.”

During an IV vancomycin infusion, a patient develops flushing and itching of the face and neck. What should the nurse do first?

1. AIgnore it, because flushing is always harmless and passes
2. BSpeed up the infusion to finish it quickly
3. CApply a warm compress to the face and neck
4. DStop or slow the infusion and inform the provider

A patient is admitted with inhalational anthrax. Which precautions are needed?

1. AStandard precautions, because it does not usually spread from person to person
2. BAirborne precautions in a negative-pressure room for the whole of the hospital stay
3. CFull contact and droplet precautions for all staff and visitors on the unit
4. DDroplet precautions with a surgical mask for everyone who enters

Which side effect of regular opioids usually needs preventive treatment from the start?

1. AHigh blood pressure
2. BDiarrhoea
3. CExcessive hunger
4. DConstipation

Un paziente ha nausea e vomito da tre giorni e assume furosemide. Quale alterazione elettrolitica è più probabile?

1. AIpercalcemia
2. BSolo ipernatriemia
3. CIperkaliemia
4. DIpokaliemia

A patient with diabetes is found unconscious with a blood glucose of 38 mg/dL (2,1 mmol/L). Which treatment is appropriate?

1. AGlucose tablets placed between the patient's teeth
2. BGlucagon by injection, or IV dextrose as prescribed
3. COrange juice poured slowly into the patient's mouth
4. DA dose of rapid-acting insulin to stabilize the glucose

Un paziente con iponatriemia cronica (sodio 118 mEq/L) è in trattamento. Perché il sodio deve essere aumentato lentamente?

1. AUna correzione rapida causa ipokaliemia, che è l'unico rischio
2. BPuò causare demielinizzazione osmotica, una grave lesione cerebrale
3. CLa correzione lenta serve solo a ridurre i costi ospedalieri
4. DUna correzione rapida fa calare di nuovo il sodio ancora di più

A patient is starting olanzapine. Which monitoring is most important over the following months?

1. AWeight, blood glucose and blood lipids
2. BPeak expiratory flow
3. CHearing tests and vision tests every month
4. DINR and platelet count

A patient starting sertraline is taught about the drug. Which statement shows a need for further teaching?

1. A"I will tell someone if I have thoughts of harming myself."
2. B"If I feel better after a week, I can stop taking it."
3. C"It may take a few weeks to feel the full effect."
4. D"I may have some nausea at first."

Septic shock belongs to which category of shock?

1. AHypovolaemic shock
2. BObstructive shock
3. CCardiogenic shock
4. DDistributive shock

A 70-year-old man has a small abdominal aortic aneurysm found on screening and is placed under surveillance. Which advice is most important?

1. AAvoid all exercise and lifting for the rest of his life to protect the aorta
2. BHave the aneurysm repaired immediately, whatever its size or growth rate
3. CStop smoking, control BP and seek help at once for sudden back pain
4. DStop all blood pressure medicines to avoid low pressure

A patient has Cushing's syndrome. Which nursing assessment is especially important?

1. AChecking for low blood pressure
2. BMonitoring for a high potassium
3. CRegular blood glucose checks
4. DWatching for weight loss

A man who takes tamsulosin for BPH is listed for cataract surgery. Which statement is correct?

1. AThe dose should be doubled before surgery to prevent urinary retention
2. BThe eye surgeon must be told, as it can cause floppy iris during surgery
3. CIt should be swapped for oxybutynin the night before to protect the eye
4. DTamsulosin has no effects outside the urinary tract, so nothing changes

Which task for a stable patient with an established ileostomy can usually be delegated to a trained healthcare assistant (nursing assistant)?

1. AEmptying the pouch and measuring the output
2. BAssessing the stoma for signs of necrosis
3. CTeaching the patient about high-output risks
4. DDeciding whether IV fluids are needed

A patient on chemotherapy has white plaques on the tongue and cheeks that wipe off to leave red areas. What is most likely?

1. AOral candidiasis
2. BFood residue only
3. CNormal mucositis healing
4. DLeukoplakia from smoking

A woman at 16 weeks has an amniocentesis. Which instruction after the procedure is correct?

1. ADrink no fluids for 24 hours
2. BReport fever, leaking fluid or bleeding
3. CBed rest is required for 2 weeks
4. DNo follow-up is needed for any symptoms

Sei ore dopo il parto una donna non ha urinato. Il fondo è flaccido e spostato a destra e il sanguinamento è aumentato. Perché è una priorità?

1. AUna vescica piena impedisce all'utero di contrarsi e aumenta il sanguinamento
2. BUna vescica piena è un segno di normale recupero
3. CDimostra che l'epidurale funziona ancora bene
4. DLa ritenzione urinaria conta solo dopo un parto cesareo, non dopo uno vaginale

Which nursing action is correct for a newborn receiving phototherapy?

1. AKeep the baby fully dressed under the lights to prevent heat loss
2. BStop feeds during phototherapy so that bilirubin falls faster
3. CApply a moisturising lotion to the skin before each session to prevent drying under the lights
4. DCover the eyes, expose as much skin as possible and monitor temperature and hydration

Which finding in a teenager with anorexia nervosa most clearly suggests the need for hospital admission?

1. AWanting to exercise every day
2. BWeighing 2 kg less than at last month's clinic visit
3. CFainting episodes with a very slow heart rate and low potassium
4. DMissing one menstrual period after starting a new diet

Un paziente passa da un IMAO a un SSRI. Che cosa è essenziale?

1. AIniziare l'SSRI lo stesso giorno
2. BUn periodo di sospensione (washout) di circa 2 settimane prima di iniziare l'SSRI
3. CAssumere entrambi i farmaci insieme per un mese
4. DRaddoppiare la dose di SSRI all'inizio

A nurse notices that a colleague smells of alcohol, has slurred speech and is about to give medicines. What should the nurse do?

1. AGive the colleague some strong coffee and let her continue with the medicine round if she says she feels fine
2. BWait until the end of the shift, then talk privately with the colleague
3. CReport the concern immediately to the nurse in charge, following policy, to protect patients
4. DSay nothing, because it is not her responsibility

Esercizio di pratica (valori inventati, non indicazioni cliniche). Un paziente è alto 5 ft 8 in. Usando 1 ft = 12 in e 1 in = 2,54 cm, trova l’altezza h in centimetri, al centimetro intero più vicino.

Esercizio di pratica (valori inventati, non indicazioni cliniche). Un’infusione inizia alle 22:50 e termina alle 06:45 della mattina dopo (orologio a 24 ore). Quanti minuti t è durata?

A un bambino di 40 kg vengono prescritti 4 mg/kg di un farmaco. La soluzione madre contiene 20 mg/mL. Aspira la dose: quale volume V somministri?

A un bambino di 28 kg vengono prescritti 5 mg/kg per dose di una sospensione orale che contiene 125 mg in 5 mL. Quale volume V somministri?

Sono stati prescritti 500 mL in 8 ore. Dopo 6 ore trovi che nella sacca restano ancora 160 mL, e l’infusione deve comunque terminare in orario. A quale velocità R in mL/h va reimpostata la pompa?

Una sacca contiene 250 mg di un farmaco in 100 mL e scorre a 20 mL/h. Quanti milligrammi all'ora D riceve il paziente?

Esercizio di pratica (valori inventati, non indicazioni cliniche). La scheda riporta le entrate e le uscite di un paziente per un turno di 12 ore. Il paziente pesa 109 kg. Trova la diuresi media U in mL/kg/h. Arrotonda a due cifre decimali.

Esercizio di pratica (valori inventati, non indicazioni cliniche). Un’infusione da 1000 mL inizia alle 17:30 a 120 mL/h. Dopo 4 ore la velocità viene portata a 150 mL/h e non viene più modificata. Dopo quante ore t dall’inizio la sacca sarà vuota? Arrotonda a una cifra decimale.

Esercizio di pratica (valori inventati, non indicazioni cliniche). Un paziente ha un polso di 66/min e una pressione arteriosa di 135/88 mmHg. Trova lo shock index SI = FC/PAS. Arrotonda a due decimali.

Esercizio di pratica (valori inventati, non indicazioni cliniche). Usa la tabella NEWS2 (SpO₂ scala 1) per queste osservazioni: frequenza respiratoria 20/min, SpO₂ 93% in aria ambiente, pressione arteriosa 130/78 mmHg, polso 104/min, vigile, temperatura 38,8 °C. In quale gruppo di rischio clinico rientra il paziente? Clicca su di esso.

1. 1basso
2. 2medio-basso
3. 3medio
4. 4alto