Priorità e delega in stile NCLEX: pacchetto last-minute

A patient is receiving a blood transfusion. Which task can the nurse delegate to a nursing assistant?

1. AStarting the transfusion once the blood arrives
2. BDeciding whether to stop the transfusion if the patient has chills
3. CAssessing the patient for signs of a transfusion reaction
4. DMeasuring and reporting vital signs at the times set by the nurse

Quale paziente richiede per primo l'attenzione dell'infermiere?

1. AUn paziente che dice di avere "il peggior mal di testa della mia vita", comparso all'improvviso, con pressione arteriosa 170/100 mmHg
2. BUn paziente con dolore cronico alla schiena che chiede una borsa calda
3. CUn paziente con emicranie note che ha un mal di testa simile ai suoi soliti
4. DUn paziente con ipertensione di lunga data la cui pressione arteriosa è 158/94 mmHg e che non ha sintomi

An order uses the abbreviation “MS”. Why is this unsafe?

1. AIt is the abbreviation for milliseconds, not a drug
2. BIt can mean either morphine sulfate or magnesium sulfate
3. CIt is reserved for drugs used in multiple sclerosis
4. DIt means the drug must be given by mouth only

Un reparto tiene flaconi di cloruro di potassio concentrato nell'armadio delle scorte. Perché molte linee guida di sicurezza lo sconsigliano?

1. AIl cloruro di potassio è troppo costoso per essere tenuto come scorta generale di reparto
2. BIl concentrato non diluito somministrato per errore può fermare il cuore
3. CI flaconi di cloruro di potassio scadono entro un giorno dall'apertura
4. DIl cloruro di potassio deve sempre essere somministrato per bocca

A patient with hyponatremia from SIADH starts tolvaptan. Why is the serum sodium checked frequently in the first day?

1. AThe sodium always falls further
2. BThe sodium can rise too quickly
3. CThe drug lowers blood glucose sharply
4. DThe drug causes severe hyperkalemia

A patient with long-standing rheumatoid arthritis has a hemoglobin of 10,5 g/dL (105 g/L), a low serum iron, a low total iron-binding capacity (TIBC) and a high-normal ferritin. Which condition fits best?

1. AIron-deficiency anemia
2. BAnemia of chronic disease (inflammation)
3. CAcute blood loss anemia
4. DVitamin B₁₂ deficiency anemia

In UK guidance, neutropenic sepsis is commonly defined by a temperature above 38 °C or signs of sepsis with a neutrophil count at or below:

1. A0,5 × 10⁹/L
2. B5 × 10⁹/L
3. C15 × 10⁹/L
4. D150 × 10⁹/L

A patient with suspected appendicitis says the pain suddenly eased, but an hour later has pain all over the abdomen, a rigid abdomen and a fever. What is most likely?

1. AThe appendix has perforated, causing peritonitis
2. BThe appendicitis has resolved without treatment
3. CThe analgesia has started working
4. DThe patient has developed gastroenteritis

A patient taking simvastatin drinks a large glass of grapefruit juice every morning. Why is this a concern?

1. AIt raises statin levels and the risk of muscle damage
2. BIt causes the cholesterol level to rise sharply
3. CIt turns the statin into a blood thinner
4. DIt stops the statin from being absorbed from the gut at all

A healthcare assistant (unlicensed assistive personnel) reports four observations. Which one needs the nurse's attention first?

1. AA patient with a DVT whose leg is less swollen today
2. BA patient after a PCI asking for a cup of tea
3. CA patient with heart failure who is newly confused, with SpO₂ 89%
4. DA patient with COPD whose SpO₂ is 90% on 1 L/min, which is usual for him

Which CSF result is most typical of bacterial meningitis?

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

A patient with hypopituitarism needs both hydrocortisone and levothyroxine. Which is usually started first?

1. ABoth on the same day, in any order
2. BNeither, until symptoms appear
3. CLevothyroxine
4. DHydrocortisone

How are skin staples usually removed from a healed incision?

1. AAlternate staples first, then the rest if the wound holds
2. BOnly the staples at each end, leaving the others for good
3. CAll staples at once by pulling each one straight up from the skin
4. DThe staples are left in permanently under the skin

A patient taking oral capecitabine reports red, painful, peeling palms and soles. What should the nurse do?

1. ATell the patient to take a double dose next time
2. BAdvise hot soaks for the hands and feet
3. CReassure that it is a sign of an unrelated allergy to washing powder
4. DReport it; this is hand-foot syndrome and treatment may need changing