Priorità e delega in stile NCLEX: pacchetto last-minute

A patient’s peripheral IV site is swollen, pale and cool, and the infusion has slowed. What should the nurse do first?

1. AIncrease the infusion rate to overcome the resistance
2. BStop the infusion and remove the cannula
3. CApply a tight bandage over the site to reduce swelling
4. DFlush the cannula hard to clear the blockage

Which patient is the best choice for the room closest to the nurses’ station?

1. AA young adult waiting for discharge tomorrow
2. BA confused older adult at high risk of falls
3. CA patient admitted for a planned scan, feeling well
4. DA patient with stable diabetes who walks independently

A colleague has drawn up a medication and asks the nurse to give it to her patient. What should the nurse do?

1. AGive it, as long as the syringe has a label with the drug name on it
2. BGive it, because the colleague is experienced
3. CDecline, and give only medications that the nurse prepared or checked personally
4. DGive it, and document that the colleague prepared it

A patient is on contact precautions. Which task is appropriate for the nurse to delegate to assistive personnel?

1. ADeciding when the precautions can be stopped
2. BHelping the patient bathe while wearing a gown and gloves
3. CAssessing the wound for new signs of infection during the bath
4. DTeaching the family how to follow the precautions

A patient with suspected pulmonary TB needs sputum samples for acid-fast bacilli. Which instruction is correct?

1. AGive one sample after brushing with mouthwash so it is clean
2. BGive one sample of saliva collected from the mouth at any time of day
3. CGive several deep-cough samples, often first thing in the morning
4. DGive several samples of nasal mucus blown into a tissue

Four patients had a thyroidectomy earlier today. Which result should the nurse act on first?

1. AHemoglobin 12,1 g/dL (121 g/L) after surgery
2. BCalcium 7,2 mg/dL (1,8 mmol/L) with tingling lips
3. CSodium 136 mEq/L on IV fluids after surgery
4. DGlucose 145 mg/dL (8,0 mmol/L) after surgery

Quale farmaco si usa per antagonizzare l'eparina non frazionata?

1. AProtamina solfato
2. BVitamina K (fitomenadione)
3. CNaloxone
4. DFlumazenil

Why must a unit of red cells be transfused within the set time limit (commonly four hours) after it leaves controlled cold storage?

1. ABacteria can grow in the blood at room temperature
2. BThe blood group of the cells changes after a few hours
3. CThe red cells break down and turn into plasma
4. DThe bag stops dripping after four hours

Why are IV fluids given cautiously to a patient with heart failure?

1. AIV fluids directly damage the heart valves
2. BIV fluids stop diuretics from being absorbed
3. CExtra volume can quickly cause pulmonary oedema
4. DIV fluids lower the blood pressure dangerously

A patient with severe COPD has increasing ankle oedema and a raised JVP, but no crackles and a normal left ventricle on echocardiography. Which condition is most likely?

1. ADeep vein thrombosis
2. BCor pulmonale
3. CAortic stenosis
4. DLeft ventricular failure

A patient has just started haemodialysis. What usually happens to their protein needs?

1. AThey increase, because dialysis removes amino acids
2. BThey fall to almost zero to rest the kidneys
3. CProtein must be replaced only by IV infusion
4. DThey stay exactly the same as they were before dialysis

A patient with CKD has a high phosphate, a low calcium and a high PTH. What does this show?

1. AHypoparathyroidism after neck surgery
2. BPrimary hyperparathyroidism from a tumour
3. CToo much vitamin D from supplements
4. DSecondary hyperparathyroidism from CKD

When is cold therapy most useful for pain?

1. AOver numb areas where sensation is lost
2. BDirectly on skin with poor circulation
3. CSoon after an acute soft tissue injury, to reduce swelling
4. DFor long-term muscle stiffness, applied continuously for several hours

A worker has a hydrofluoric acid burn on the hand and severe pain. After irrigation with water, which specific treatment is commonly applied?

1. ACalcium gluconate gel
2. BIce cubes wrapped in a cloth
3. CSilver sulfadiazine cream
4. DSodium bicarbonate paste