Priorità e delega in stile NCLEX: pacchetto last-minute

Which patient should the RN see first after receiving a report from the night nurse?

1. ADay 2 after bowel surgery, asking to start a soft diet
2. BDay 1 after bowel surgery, new chest pain and heart rate 110/min
3. CDay 3 after bowel surgery, wants a shower and hair wash before breakfast
4. DDay 4 after bowel surgery, waiting for discharge teaching

A patient with a severe asthma attack had a PaCO₂ of 32 mmHg (4,3 kPa) on arrival. An hour later it is 46 mmHg (6,1 kPa), and the patient seems tired. What does this suggest?

1. AThe patient is hyperventilating even more than before and needs calming
2. BRespiratory muscle fatigue with possible impending respiratory failure
3. CThe asthma is improving, because the PaCO₂ is now near normal
4. DA laboratory error that should be ignored

Which measure reduces errors caused by interruptions during medication preparation?

1. APreparing medications at the busiest place on the ward
2. BAnswering phone calls and pages while counting tablets, to save time
3. CPreparing medications for all patients at once
4. DA quiet “no interruption” zone or signal while preparing medications

An audit shows poor hand hygiene compliance on a ward. Which plan is most likely to improve it?

1. AA combined approach with education, hand rub at every bedside, regular audits and feedback
2. BA single poster about hand hygiene placed in the staff room
3. CRemoving all sinks so staff must use hand rub
4. DDisciplining staff who are seen not cleaning their hands, with no other change

A patient with diabetes also takes propranolol. Why is regular glucose monitoring especially important?

1. AThe drug can mask warning signs of hypoglycemia
2. BThe drug stops the meter from reading correctly
3. CThe drug blocks the insulin injection site
4. DThe drug causes very high glucose in all patients

A patient with long-standing rheumatoid arthritis has a hemoglobin of 10,5 g/dL (105 g/L), a low serum iron, a low total iron-binding capacity (TIBC) and a high-normal ferritin. Which condition fits best?

1. AAcute blood loss anemia
2. BVitamin B₁₂ deficiency anemia
3. CIron-deficiency anemia
4. DAnemia of chronic disease (inflammation)

Quale valutazione individua meglio una sindrome compartimentale dopo il gesso su una gamba fratturata?

1. AUn piede caldo e roseo
2. BLieve prurito sotto il gesso
3. CDolore sproporzionato rispetto alla lesione, soprattutto all'estensione passiva
4. DUn polso forte al piede

During a general anaesthetic, a patient develops a rapidly rising temperature, muscle rigidity and rising carbon dioxide levels. What should be suspected?

1. ANeuroleptic malignant syndrome from antipsychotics
2. BPostoperative infection
3. CA normal response to surgery
4. DMalignant hyperthermia

A patient is going home with a 24-hour Holter monitor. Which instruction is most important?

1. AShower as normal with the monitor on
2. BRemove the monitor whenever symptoms occur and restart it
3. CKeep a diary of symptoms and activities with the times
4. DStay in bed for the full 24 hours so the trace is clear

A patient with a stab wound to the chest has a hole that sucks air with each breath. What is the immediate management?

1. ASeal it completely with tape on all four sides and leave it alone
2. BPack the wound tightly with gauze pushed deep into the chest
3. CCover it with a vented chest seal or a dressing taped on three sides
4. DLeave it open and give a nebuliser

Why are patients with an acute spinal cord injury at high risk of deep vein thrombosis?

1. AThey usually take oestrogen as part of their treatment
2. BParalysed leg muscles no longer pump blood back to the heart
3. CThe injury makes the blood too thin to clot properly in the veins
4. DSpinal injuries always damage the large veins of the legs

A 74-year-old falls forward and hits their chin. Their arms are much weaker than their legs, and they have burning pain in the hands. Which injury is most likely?

1. ABrown-Séquard syndrome
2. BA complete lumbar cord injury
3. CCauda equina syndrome
4. DCentral cord syndrome

Un paziente con cirrosi assume lattulosio per l'encefalopatia epatica. Qual è l'obiettivo abituale?

1. ADue o tre evacuazioni morbide al giorno
2. BNessuna evacuazione per diversi giorni
3. CDieci o più evacuazioni liquide al giorno
4. DUn'evacuazione dura a settimana

Four patients from a house fire arrive in the emergency department. Which should the nurse assess first?

1. APartial-thickness burns to both legs, with pain rated 8/10
2. BA blistered forearm burn and a small cut on the knee
3. CCircumferential chest burns, with breathing becoming shallow and laboured
4. DRedness on the backs of both hands, and very anxious