Priorità e delega in stile NCLEX: pacchetto last-minute

Which patient with diabetes should the nurse see first?

1. ANeeds foot care teaching before discharge tomorrow
2. BGlucose 48 mg/dL (2,7 mmol/L), sweating and confused
3. CGlucose 210 mg/dL (11,7 mmol/L) after a large lunch, feels well
4. DHbA1c result of 8,2%, asking about diet

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

A patient has a very low platelet count. Which safety measure is appropriate?

1. AUse a soft toothbrush and an electric razor
2. BUse a firm toothbrush and a safety razor
3. CFloss hard each day to keep the gums healthy
4. DTake rectal temperatures for accuracy

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. AGive written instructions in English only
2. BUse a professional medical interpreter
3. CLet the child interpret, because the family prefers it
4. DUse simple English and many hand gestures

A patient has had severe watery diarrhea for 4 days. Which laboratory pattern would the nurse expect?

1. AHigh sodium and high calcium
2. BHigh potassium and high bicarbonate
3. CLow potassium and low bicarbonate
4. DLow glucose and high magnesium

Which patient's result should the nurse act on first?

1. AHemoglobin 6,4 g/dL (64 g/L) with new chest pain and a pulse of 124/min
2. BPlatelets 140 × 10³/µL in a patient with mild chronic liver disease
3. CFerritin 15 ng/mL in a well patient with known iron-deficiency anemia on oral iron
4. DHemoglobin 9,6 g/dL (96 g/L) in a patient with stable chronic kidney disease

A patient is having a 12-lead ECG. Where are the chest electrodes placed?

1. AOn both shoulders and both hips only
2. BIn standard numbered positions across the front and left of the chest
3. CAnywhere on the chest where the skin is clear
4. DIn a straight line down the centre of the sternum from top to bottom

Un paziente con asma grave diventa silenzioso, con «torace silente», esaurimento e frequenza respiratoria in calo. Che cosa indica?

1. AUna normale ripresa dopo un aerosol
2. BSolo ansia
3. CUn miglioramento dell'attacco man mano che il broncospasmo si risolve e le vie aeree si rilassano
4. DAsma pericoloso per la vita con imminente arresto respiratorio

After an above-knee amputation, which measure helps prevent a hip flexion contracture?

1. AKeeping the hip bent to reduce stump swelling
2. BKeeping a pillow under the stump at all times, day and night
3. CLying prone for periods and avoiding pillows under the stump
4. DSitting in a chair for most of the day with the hips bent

After six weeks of treatment for tuberculosis, a patient has nausea, dark urine and yellow eyes. What should the nurse do?

1. AWithhold the next doses and report urgently for liver tests
2. BDouble the isoniazid dose to clear the infection faster
3. CReassure the patient that the urine colour is due to rifampicin
4. DAdvise taking the tablets with an alcoholic drink to settle the stomach

Which approach helps most when talking to a patient with expressive aphasia?

1. AAvoid talking to them until their speech has recovered
2. BAsk questions that can be answered with yes, no or a gesture
3. CSpeak louder, because the patient cannot hear well
4. DFinish their sentences quickly to save them effort

A nurse teaches a carer to give buccal midazolam for prolonged seizures. Which statement shows a need for further teaching?

1. A"I will write down the time the seizure started and the time I gave the dose."
2. B"I will give it into the space between his gum and cheek."
3. C"I will call an ambulance if the care plan tells me to."
4. D"I will put something between his teeth so he does not bite his tongue."

Which is a usual benefit of laparoscopic over open abdominal surgery?

1. ANo risk of any complications at all
2. BNo need for a general anaesthetic ever
3. CLarger wounds that heal faster
4. DLess pain and a shorter hospital stay

During burn resuscitation, a 70 kg adult's urine output has been 120 mL/h for 3 hours, and the face and limbs are very oedematous. What should the nurse do?

1. ADiscuss reducing the fluid rate with the team
2. BIncrease the fluid rate to keep the output high
3. CGive a diuretic without discussing it
4. DStop all IV fluids completely and remove the catheter