Priorità e delega in stile NCLEX: pacchetto last-minute

A nurse cannot read part of a medication order. What should the nurse do?

1. AContact the prescriber to clarify the order before giving the drug
2. BAsk another nurse to guess what the order most likely says, then give it
3. CSkip the drug and not tell anyone until the next ward round
4. DGive the usual dose of the drug the nurse thinks was meant

Two days after starting haloperidol, a patient suddenly develops painful neck twisting and the eyes roll upwards. What should the nurse anticipate?

1. ANo action, because the spasm is a sign of improvement
2. BPhysical restraint until the spasm passes
3. CA higher dose of haloperidol to calm the patient and stop the movements quickly
4. DAn anticholinergic drug, such as benztropine or procyclidine, as prescribed

When should a nurse call the rapid response team?

1. AOnly when the provider has written an order for a rapid response call in the chart
2. BOnly after a patient has had a cardiac or respiratory arrest on the ward
3. CWhen a patient shows an acute decline, such as new confusion or a sharp change in vital signs
4. DOnly when the patient’s family makes a complaint

Over a few hours, the emergency department sees many previously healthy people with the same unusual severe symptoms. What should the nurse do?

1. ATreat each patient and wait to see if more arrive next week
2. BTell only the patients’ families about the pattern
3. CReport it to infection prevention and public health authorities promptly
4. DSend the patients home quickly to avoid crowding the emergency department

A patient is starting atorvastatin. Which laboratory test is usually checked at baseline?

1. ABlood cultures
2. BSerum lipase
3. CLiver enzymes
4. DThyroid antibodies

Un paziente con un calcio di 6,8 mg/dL (1,7 mmol/L) sviluppa all'improvviso un respiro rumoroso e una voce rauca. Che cosa suggerisce?

1. AUna risposta normale che passerà senza trattamento
2. BLaringospasmo, un'emergenza che richiede aiuto urgente e calcio endovena
3. CAnsia per i risultati del sangue, che richiede una calma rassicurazione
4. DUn raffreddore comune iniziato questa mattina

Why are people with diabetes advised to have regular eye screening?

1. ATo detect diabetic retinopathy early, before sight is lost
2. BTo check whether they need reading glasses for close work
3. CTo prevent conjunctivitis
4. DTo measure their blood glucose through the eye

A patient who used sildenafil the day before develops chest pain. Why is glyceryl trinitrate (GTN, nitroglycerin) normally avoided?

1. AThe combination causes severe hyperkalaemia
2. BSildenafil stops GTN from being absorbed under the tongue at all
3. CGTN makes sildenafil toxic to the liver
4. DThe combination can cause a severe, dangerous fall in blood pressure

Why is aspirin chewed rather than swallowed whole in a suspected acute coronary syndrome?

1. AChewing stops the aspirin from irritating the lining of the stomach
2. BChewing changes aspirin into an anticoagulant
3. CChewing speeds absorption, giving a faster antiplatelet effect
4. DWhole aspirin tablets cannot be absorbed at all from the gut

A patient is going home after a spontaneous pneumothorax treated with a chest drain. Which advice is correct?

1. AStop smoking and do not fly until a doctor confirms full resolution
2. BFly home as soon as possible so they can recover in comfort there
3. CExpect it never to happen again, so no follow-up is needed
4. DTake up scuba diving to strengthen the lungs

Which headache feature most suggests raised intracranial pressure from a brain tumour?

1. AWorse on waking and on coughing, with vomiting
2. BOnly present after reading for a long time
3. CBetter in the morning and worse with stress
4. DA tight band across the forehead that eases with rest

A patient with a long-term catheter has fever and rigors, and a catheter UTI is suspected. Which action is recommended before starting antibiotics?

1. AFlush the catheter with saline and continue
2. BReplace the catheter and take a sample from the new one
3. CRemove the catheter and leave it out permanently
4. DTake a sample from the drainage bag and send it to the lab

Quale consiglio alimentare riduce il rischio di ostruzione con una nuova ileostomia?

1. AMasticare bene e introdurre lentamente gli alimenti ricchi di fibre
2. BBere pochissimo per mantenere denso l'output
3. CMangiare molta frutta secca e semi fin dal primo giorno
4. DDeglutire rapidamente il cibo senza masticare molto

After forearm fracture surgery, a patient has severe pain not eased by opioids, made worse by passively moving the fingers. What should the nurse do?

1. AReassure the patient that this pain is expected
2. BLoosen any tight dressing, keep the arm at heart level and escalate
3. CRaise the arm as high as possible and give a further dose of opioid
4. DApply ice and a tighter bandage to reduce the swelling