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. BA personality change that is permanent and expected
3. CNormal aging that needs no action
4. DLong-standing dementia that is expected

Using ESI, a stable adult with abdominal pain will need blood tests and a CT scan, but has a heart rate of 130/min. Which statement is correct?

1. AThe patient is level 5 because the pain is not severe
2. BVital signs never change the ESI level
3. CThe patient is level 4 because the blood tests and the scan count as one resource
4. DThe nurse should consider level 2 because of the danger-zone vital sign

Quale prodotto per la pulizia è raccomandato per la stanza di un paziente con Clostridioides difficile?

1. AUn agente sporicida, come una soluzione a base di cloro
2. BUno spray deodorante profumato
3. CSalviette alcoliche, usate su tutte le superfici due volte al giorno
4. DSolo acqua e un panno in microfibra pulito

A nurse cannot find a confused patient who was in their room 15 minutes ago. What should the nurse do first?

1. ADocument the absence at the end of the shift
2. BAlert staff and security at once, following the missing-patient procedure
3. CWait an hour in case the patient comes back
4. DCall the family to ask whether the patient has gone home on their own

Why is a baseline platelet count taken before starting heparin therapy?

1. ASo a later fall from heparin-induced thrombocytopenia is detected
2. BSo that the INR can be calculated from the platelet count later
3. CBecause heparin is given at a dose based on the platelet count
4. DBecause heparin increases the platelet count to dangerous levels

A patient has marked generalized edema. Results show heavy proteinuria, serum albumin 1,8 g/dL (18 g/L) and total cholesterol 340 mg/dL (8,8 mmol/L). Which condition fits best?

1. ANephrotic syndrome
2. BPrerenal kidney injury
3. CLiver cirrhosis only
4. DAcute pyelonephritis

Why is an ankle–brachial pressure index (ABPI) measured before applying compression bandages to a leg ulcer?

1. ATo exclude significant arterial disease, as compression could cut off blood flow
2. BTo check for a urinary tract infection that could delay ulcer healing
3. CTo measure how deep the ulcer is and how much exudate it produces
4. DTo work out the patient's fluid needs

Which action is most important in protecting a patient with severe neutropenia from infection?

1. AGiving routine intramuscular injections
2. BTaking rectal temperatures regularly
3. CStrict hand hygiene by everyone who has contact with the patient
4. DKeeping fresh flowers and plants in the room to help the patient's mood

A patient with COPD is prescribed long-term oxygen therapy. How many hours a day is it usually needed to improve survival?

1. AAt least 15 hours a day
2. BOnly during meals
3. CAbout one hour each morning
4. DOnly when walking outside

A patient receiving weeks of IV antibiotics through a PICC line in the left arm develops swelling and aching of that arm and neck veins that look fuller on the left. What should the nurse suspect?

1. ALymphoedema from lying in bed
2. BA catheter-related deep vein thrombosis
3. CAn expected effect of the antibiotic
4. DA local skin allergy to the dressing

Why is propranolol given to a patient with hyperthyroidism?

1. ATo ease tremor and palpitations while other treatment starts
2. BTo stop the thyroid gland from making any more hormones
3. CTo replace the hormone lost from the thyroid gland
4. DTo destroy overactive thyroid tissue over a few weeks

A nurse teaches a woman with recurrent UTIs. Which statement shows a need for further teaching?

1. A"I will wipe from front to back."
2. B"I will drink enough fluids during the day."
3. C"I will pass urine soon after sex."
4. D"I will hold my urine for as long as I can."

Why are carbohydrate drinks often given before surgery in enhanced recovery programmes?

1. ATo replace the need for any IV fluids afterwards
2. BTo make the bowels open before the operation
3. CTo raise the blood pressure during the anaesthetic
4. DTo reduce insulin resistance and improve recovery

An 80-year-old has a fluid balance 3 L positive two days after surgery. They are now breathless, with crackles at both lung bases and swollen ankles. What should the nurse do?

1. AEncourage the patient to drink more fluids
2. BIncrease the IV fluid rate to improve kidney flow
3. CStop the IV fluids, sit the patient up and escalate
4. DLie the patient flat with the legs raised