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

Why should reddened skin over a bony area not be massaged?

1. AMassage hides early signs of infection
2. BMassage makes the redness spread to other areas
3. CMassage is only allowed when done by a physiotherapist
4. DMassage can damage the deeper tissues further

A patient's notes record a penicillin allergy with a rash. The new prescription is for amoxicillin. What should the nurse do?

1. AGive half the dose and watch for a rash
2. BGive an antihistamine first, then the amoxicillin
3. CGive the dose, as amoxicillin is a different drug from penicillin itself
4. DWithhold it and contact the prescriber, as amoxicillin is a penicillin

A nurse finds an unlabeled syringe of clear fluid on the medication counter. What should the nurse do?

1. AAsk nearby staff and use it if someone recognizes it
2. BGive it to the patient whose medication is due
3. CLabel it with the most likely drug name
4. DDiscard it, because its contents cannot be confirmed

A patient who speaks little English is being discharged with new medications. The patient’s 12-year-old child offers to interpret. What should the nurse do?

1. AUse simple English and many hand gestures
2. BLet the child interpret, because the family prefers it
3. CUse a professional medical interpreter
4. DGive written instructions in English only

Which patient on an addiction unit should the nurse see first?

1. ALast drink this morning; asking when lunch will arrive
2. BIn recovery for a year; came to the clinic today for a routine check and a repeat prescription
3. CLast drink two days ago; now shaking, sweating, heart rate 124/min and seeing insects
4. DLast drink one week ago; asking about support groups

The charge nurse overhears four instructions from an RN to a nursing assistant. Which one needs to be corrected?

1. A“Walk him to the bathroom and back, and stay with him the whole time.”
2. B“Check his glucose before lunch and tell me the number straight away.”
3. C“Check his glucose and give the insulin according to the sliding scale.”
4. D“Help him wash and change, and tell me at once if you see any red or broken skin.”

Why is oxygen often humidified for a patient with a tracheostomy?

1. AHumidity is needed for the oxygen to work as a drug
2. BHumidification lowers the oxygen concentration to a safer level
3. CDry oxygen causes high blood glucose
4. DThe tube bypasses the nose, which normally warms and moistens air

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 team may override any decision that it disagrees with if it is serious
3. CThe patient must be assessed by a psychiatrist before refusing
4. DA person is not treated as lacking capacity just because they make an unwise decision

A patient with sepsis has a lactate of 2,1 mmol/L on admission and 4,3 mmol/L two hours later, despite IV fluids. What does this suggest?

1. AWorsening tissue perfusion that needs urgent reporting
2. BImproving circulation as the fluids start to work
3. CA normal response to IV fluids in the first hours
4. DExpected muscle activity from shivering in fever

A patient admitted with heavy alcohol use and malnutrition has a glucose of 52 mg/dL (2,9 mmol/L) and low magnesium. Which prescribed treatment should be given before the IV glucose?

1. AIV potassium
2. BIV insulin
3. COral iron
4. DIV thiamine

Why is testing for HLA-B*15:02 recommended before carbamazepine in people of some Asian ancestries?

1. AThis gene variant speeds up the kidney excretion of carbamazepine
2. BThis gene variant causes carbamazepine to raise blood glucose
3. CThis gene variant makes carbamazepine ineffective
4. DIt greatly raises the risk of Stevens–Johnson syndrome

Un paziente ha una reazione anafilattica alla prima dose di amoxicillina. Come si classifica questa reazione avversa nel comune sistema A/B?

1. ATipo B, perché si verifica solo dopo un uso prolungato
2. BTipo A, perché la dose era troppo alta
3. CTipo A, perché è dose-dipendente e prevedibile dalla farmacologia del farmaco
4. DTipo B, perché è imprevedibile e non correlata alla normale azione del farmaco

Which emergency equipment should be kept at the bedside of a patient with a tracheostomy?

1. AOnly a spare oxygen mask, since the tube rarely causes problems
2. BSpare tubes (same size and one smaller), suction and oxygen
3. CA urinary catheter set, a blood glucose meter and a thermometer
4. DA nasogastric tube and a feeding pump

A patient taking ramipril and indapamide for hypertension starts regular ibuprofen for back pain. A week later, creatinine has risen sharply. What is the most likely cause?

1. AIbuprofen raising the blood pressure to levels that damage the kidneys
2. BAn allergic reaction to the diuretic causing inflammation of the kidney
3. CAn ACE inhibitor, diuretic and NSAID together reducing kidney perfusion
4. DBack pain causing kidney damage

Which picture fits Brown-Séquard syndrome?

1. AWeakness on the same side and loss of pain on the opposite side
2. BParalysis of both legs, with normal sensation everywhere in the body
3. CLoss of all feeling but normal movement on both sides
4. DWeakness of both arms with normal strength in the legs

Which task can the registered nurse delegate to a trained healthcare assistant (nursing assistant)?

1. AChecking pre-meal glucose and reporting results out of range
2. BTeaching a new patient how to inject insulin
3. CDeciding the dose of correction insulin from the glucose result
4. DAssessing a confused patient whose glucose is 2,6 mmol/L (47 mg/dL)

Qual è il ruolo della restrizione del sodio e dello spironolattone nella cirrosi?

1. AAumentare la pressione arteriosa e migliorare il flusso di sangue ai reni
2. BAbbassare l'ammoniemia e trattare l'encefalopatia
3. CAumentare la perdita di potassio e prevenire l'iperkaliemia
4. DRidurre la ritenzione di sodio e acqua e controllare l'ascite

A patient with cirrhosis takes spironolactone and furosemide. Which blood result should the nurse report before the next dose?

1. ASodium 141 mmol/L
2. BPotassium 4,2 mmol/L
3. CPotassium 6,0 mmol/L
4. DSodium 138 mmol/L

Why are afterpains often stronger in multiparous women?

1. ATheir uterus contracts and relaxes more irregularly
2. BThey have a smaller uterus than first-time mothers
3. CThey produce no oxytocin after birth
4. DTheir uterus is always infected

A woman with active genital herpes lesions is admitted in early labour with intact membranes. What should the nurse expect?

1. ARupture of the membranes to speed up labour
2. BA fetal scalp electrode for close monitoring
3. CA caesarean birth to reduce the risk of neonatal herpes
4. DA vaginal birth with no special precautions

Why should a child with rubella avoid contact with pregnant women?

1. AThe child may catch a pregnancy-related infection
2. BRubella causes pregnant women to go into labour early
3. CRubella in early pregnancy can cause serious birth defects
4. DPregnant women always develop severe pneumonia if they catch rubella

Several family members, including the children, have had headaches, nausea and drowsiness all winter. They feel better when away from home. What should the nurse suspect?

1. ACarbon monoxide poisoning
2. BMigraine that runs in the family
3. CFood poisoning
4. DSeasonal influenza

Which communication approach is best for a patient with moderate dementia?

1. AAsk several questions together to save time
2. BUse short, simple sentences and give one instruction at a time
3. CUse abstract language and long explanations so the patient feels respected
4. DSpeak loudly and quickly so that the patient stays alert

A patient with schizophrenia has marked negative symptoms. He stays in bed most of the day and neglects his hygiene. Which nursing approach is most helpful?

1. AWait until he asks to join activities before involving him
2. BTell him firmly that he will lose his ward privileges unless he gets up and showers at once
3. CLet him stay in bed, because negative symptoms cannot change
4. DAgree a simple daily routine with small, achievable activities and give positive feedback

Esercizio di pratica (valori inventati, non indicazioni cliniche). La temperatura di un paziente è 40,8 °C. Convertila in gradi Fahrenheit T con °F = °C × 9/5 + 32. Arrotonda a un decimale.

Esercizio di pratica (valori inventati, non indicazioni cliniche). Un risultato dell’emoglobina è 169 g/L. Esprimilo in g/dL Hb.

Un paziente che pesa 66 kg ha una superficie corporea di 1,58 m². La prescrizione è di 75 mg/m². Trova la dose D in mg.

Un'infusione contiene 40000 unità di un farmaco in 500 mL. La prescrizione è di 1500 unità all'ora. A quale velocità R imposti la pompa, in mL/h?

Infondi 1500 mL in 12 ore con un deflussore da 15 gtt/mL. Trova la velocità di gocciolamento R in gocce al minuto. Arrotonda al numero intero più vicino.

Un’infusione di 400 mg in 500 mL scorre a 6 mL/h. Quanti microgrammi al minuto 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. L’infusione endovenosa è scorsa alla velocità indicata per l’intero turno. Trova il bilancio idrico B = entrate − uscite in mL (una risposta negativa indica una perdita netta). Conta i cubetti di ghiaccio per metà del loro volume.

Esercizio di pratica (valori inventati, non indicazioni cliniche). Un’infusione da 500 mL inizia alle 06:30 a 125 mL/h. Dopo 3 ore la velocità viene portata a 60 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 di esercitazione viene valutato con la scala di Morse per il rischio di caduta: anamnesi di cadute negli ultimi 3 mesi: sì; diagnosi secondaria: sì; ausilio per la deambulazione: nessuno, riposo a letto o assistito da un infermiere; terapia EV o catetere venoso con tappo: no; andatura: compromessa; stato mentale: sopravvaluta o dimentica i propri limiti. Trova il totale di Morse MFS.

Esercizio di pratica (valori inventati, non indicazioni cliniche). Un paziente di esercitazione viene valutato con la scala di Morse per il rischio di caduta: anamnesi di cadute negli ultimi 3 mesi: no; diagnosi secondaria: no; ausilio per la deambulazione: nessuno, riposo a letto o assistito da un infermiere; terapia EV o catetere venoso con tappo: no; andatura: normale, riposo a letto o sedia a rotelle; stato mentale: sopravvaluta o dimentica i propri limiti. Usando le soglie 0–24 basso, 25–44 moderato e 45 o più alto, clicca sul livello di rischio di caduta.

1. 1rischio basso
2. 2rischio moderato
3. 3rischio alto