Priorità e delega in stile NCLEX: pacchetto last-minute

Un paziente adulto che sta mangiando nella sala comune si porta all'improvviso le mani alla gola e non riesce a parlare, respirare o tossire. Che cosa deve fare per prima l'infermiere?

1. AFare un'estrazione cieca con il dito dalla bocca
2. BChiamare aiuto e dare colpi dorsali e compressioni addominali
3. CDare al paziente un bicchiere d'acqua per mandare giù il cibo
4. DAspettare per vedere se il paziente riesce a tossire

A patient with suspected sepsis has four prescribed orders. Which should usually be done first?

1. AArrange a chest X-ray for later today
2. BRepeat the lactate in six hours
3. CGive the IV antibiotic
4. DTake blood cultures

A patient with diabetes will use lancets and insulin needles at home. Which teaching about disposal is correct?

1. ARecap each needle with two hands before putting it in the kitchen trash
2. BPut them in a puncture-resistant container with a lid and follow local disposal rules
3. CPut them loose in the household trash bag, as long as the bag is tied shut
4. DFlush the used lancets and needles down the toilet

Which patient with a suspected infection meets at least two SIRS criteria?

1. ATemperature 37,2 °C and heart rate 80/min
2. BRespiratory rate 16/min and WBC 8,000/mm³
3. CTemperature 36,8 °C and respiratory rate 18/min
4. DTemperature 38,6 °C and heart rate 112/min

A healthy woman at 28 weeks of pregnancy has a mildly lower hemoglobin than before pregnancy, with a normal MCV and ferritin. What is the most likely explanation?

1. AIron is being lost through the kidneys during the pregnancy
2. BThe fetus is destroying the mother's red cells in the circulation
3. CPlasma volume rises more than red cell mass, diluting the blood
4. DPregnancy hormones stop the bone marrow from making red cells

A patient with acute kidney injury after severe dehydration has a rising creatinine. Which urine findings support a prerenal cause rather than acute tubular necrosis (ATN)?

1. AWhite cell casts with positive nitrites on the dipstick
2. BRed cell casts with heavy protein loss in the urine
3. CHigh urine sodium and dilute urine with muddy brown granular casts
4. DLow urine sodium and concentrated urine with a high specific gravity

A nurse finds a patient lying on the floor beside the bed. What should be done first?

1. APhone the patient's family
2. BLift the patient straight back into bed so they are comfortable
3. CCheck the patient for injuries before moving them
4. DComplete the incident report form

During a blood transfusion, an older patient with heart failure becomes breathless with a rising blood pressure, raised JVP and crackles in the lungs. What is the most likely cause?

1. ATransfusion-associated circulatory overload
2. BTransfusion-related acute lung injury with hypotension
3. CA febrile non-haemolytic reaction
4. DAnaphylaxis

Suspected pulmonary TB is being investigated. How are sputum samples usually collected?

1. AA single sample after the first week of treatment
2. BSeveral samples, ideally including early-morning sputum
3. COne sample of saliva collected at any time of the day
4. DA swab from the nose only

Il drenaggio toracico di un paziente viene sfilato accidentalmente. Qual è l'azione immediata?

1. ASigillare il sito con una medicazione occlusiva sterile e chiedere aiuto
2. BLasciare il foro scoperto così l'aria intrappolata può uscire
3. CChiedere al paziente di tossire forte per espandere il polmone
4. DSpingere il drenaggio di nuovo nel torace e fissarlo con del cerotto

Which CSF result is most typical of bacterial meningitis?

1. AClear fluid with normal cells, glucose and protein
2. BBlood-stained fluid that clears in later tubes
3. CClear fluid, many lymphocytes, normal glucose and slightly raised protein
4. DCloudy fluid, many neutrophils, low glucose and high protein

Two days after surgery, an 80-year-old woman is quiet, sleepy, slow to answer and eating little. Her daughter says she is "not herself". What should the nurse suspect?

1. AHypoactive delirium
2. BNormal tiredness after an operation
3. CThe start of Alzheimer's disease
4. DSimple low mood about being in hospital

Dysphagia that started with solids and now includes liquids, with weight loss, most suggests which cause?

1. ASimple anxiety about swallowing tablets
2. BA narrowing such as an oesophageal tumour
3. CNormal ageing of the swallowing muscles
4. DA dry mouth from drinking too little water

Quale regola di sicurezza si applica alla vincristina?

1. ADi solito si somministra per via intratecale con altri farmaci spinali
2. BSi somministra al meglio come rapido push EV in una piccola vena
3. CPuò essere somministrata per la via preferita dal prescrittore
4. DMai per via intratecale; fornita in una minibag solo per uso EV