Priorità e delega in stile NCLEX: pacchetto last-minute

An older patient becomes confused over a few hours, with attention that comes and goes. What does this suggest?

1. ADelirium, which needs the cause found quickly
2. BNormal aging that needs no action
3. CA personality change that is permanent and expected
4. DLong-standing dementia that is expected

Which patient is the most appropriate to assign to an LPN/LVN?

1. AA patient who has just arrived from the emergency department with pneumonia and confusion
2. BA patient with a long-standing tracheostomy who needs routine suctioning and care
3. CA patient on a new IV medication that needs frequent titration
4. DA patient with a tracheostomy placed this morning who is coughing up blood

Perché i farmaci liquidi orali si somministrano con siringhe orali o enterali anziché con comuni siringhe endovenose?

1. ALe siringhe orali non si adattano alle linee endovenose, evitando errori di via di somministrazione
2. BLe siringhe endovenose non misurano con precisione piccoli volumi di liquido orale
3. CNon c'è alcun motivo di sicurezza; è solo tradizione
4. DLe siringhe orali misurano con maggiore precisione le dosi endovenose

The laboratory reports that a blood sample labeled with one patient’s name has a blood group different from that patient’s previous result. What is the most likely problem and response?

1. AA normal change in the patient’s blood group over the years since the last test
2. BA wrong-patient sample, so the test is repeated and the event reported
3. CA laboratory machine fault, so no action is needed
4. DThe previous result was wrong, so it is deleted

A patient with hyperkalemia received IV regular insulin with dextrose. Which result must the nurse monitor closely over the next hours?

1. ASerum calcium, because it falls sharply
2. BHemoglobin, because insulin causes red cell loss
3. CSerum sodium, because it rises quickly
4. DBlood glucose, because hypoglycemia can occur

A patient's low calcium does not improve despite several days of calcium replacement. Which other electrolyte should be checked and corrected?

1. AChloride
2. BBicarbonate
3. CMagnesium
4. DSodium

A confused patient keeps trying to climb out of bed. Why are bed rails not automatically the answer?

1. APatients can be seriously injured climbing over or becoming trapped in rails
2. BBed rails always make patients more confused, but only during the day
3. CBed rails stop staff from taking observations
4. DBed rails are illegal in all hospitals and must never be used at all

Which drug group is first-line for a prolonged convulsive seizure?

1. ABeta-blockers, such as bisoprolol or atenolol
2. BOpioids, such as morphine or diamorphine, given intravenously
3. CBenzodiazepines, such as buccal midazolam or IV lorazepam
4. DAntihistamines, such as chlorphenamine

Un paziente con dolore toracico chiede nitroglicerina. Quale informazione significa che l'infermiere deve sospenderla e contattare il prescrittore?

1. ALa pressione arteriosa del paziente è 150/90 mmHg
2. BIl paziente ha assunto sildenafil oggi
3. CIl paziente ha avuto mal di testa la settimana scorsa
4. DIl paziente assume una statina ogni giorno

A patient is listed for coronary angiography in the morning. Which pre-procedure result should the nurse report to the team?

1. AA haemoglobin in the normal range
2. BA markedly reduced eGFR
3. CA blood glucose of 5,4 mmol/L (97 mg/dL)
4. DA normal platelet count

Which signs suggest rejection of a kidney transplant?

1. AMore urine, a falling creatinine and weight loss
2. BA cough, wheeze and a runny nose with sneezing
3. CLess urine, a rising creatinine and a tender graft
4. DA rash on the face after sun exposure

A patient with CKD has a potassium of 6,5 mmol/L. Which medicine combination is the most likely contributor?

1. ARamipril, spironolactone and trimethoprim
2. BAmlodipine, simvastatin and aspirin
3. CParacetamol (acetaminophen), omeprazole and senna
4. DFurosemide, salbutamol and insulin

Which diet is usually recommended for a patient with cirrhosis and hepatic encephalopathy?

1. AOnly clear fluids for several weeks
2. BNormal protein and enough calories, with a late-evening snack
3. CNo food at all until the confusion settles
4. DA very low-protein diet for the rest of their life to lower ammonia

On day 3 after surgery, a patient has a temperature of 38,6 °C, respiratory rate 24/min, pulse 118/min, BP 92/58 mmHg and new confusion. What should the nurse do?

1. AGive paracetamol and recheck in four hours
2. BEncourage oral fluids and wait for the doctor's round
3. CRecord the observations and continue routine care
4. DEscalate urgently and start the sepsis pathway