Priorità e delega in stile NCLEX: pacchetto last-minute

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

1. AGive the usual dose of the drug the nurse thinks was meant
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. DContact the prescriber to clarify the order before giving the drug

An 85-year-old resident becomes newly confused and is falling, but has no fever. Which cause should the nurse consider first?

1. ABoredom from not having enough activities
2. BA sudden worsening of long-standing dementia that needs no tests
3. CAn infection, such as a urinary tract infection, presenting atypically
4. DNormal aging that needs no assessment

A woman who is pregnant asks for the MMR vaccine because she is not immune to rubella. What is correct?

1. AMMR is a live vaccine and is not given during pregnancy, but can be given after delivery
2. BMMR should be given as soon as possible in the first trimester to protect the baby
3. CMMR is safe at any stage of pregnancy
4. DMMR is only given to pregnant women who work in hospitals

A hospital will introduce new infusion pumps and wants to find out how the process could fail before any harm occurs. Which method fits best?

1. AA morbidity and mortality meeting
2. BRoot cause analysis (RCA) of the new pumps
3. CFailure mode and effects analysis (FMEA)
4. DAn incident report for each new pump

A patient with chronic kidney disease has a magnesium of 3,8 mEq/L (1,9 mmol/L). Which product is the most likely cause?

1. AMagnesium-containing laxatives or antacids
2. BExcess alcohol use over many years
3. CLoop diuretics such as furosemide
4. DProton pump inhibitors taken long term

A middle-aged man has fatigue, joint pain, a raised ALT and new diabetes. His ferritin is very high and his transferrin saturation is above 60%. Which condition is most likely?

1. AAnemia of chronic disease
2. BAcute viral hepatitis A
3. CHereditary hemochromatosis
4. DIron-deficiency anemia

How does ulcerative colitis differ from Crohn's disease?

1. AUlcerative colitis can affect any part of the gut from mouth to anus
2. BUlcerative colitis typically causes patchy "skip" lesions
3. CUlcerative colitis always affects the full thickness of the bowel wall
4. DUlcerative colitis affects only the colon, continuously from the rectum

A patient is admitted with suspected meningococcal disease. Which infection control measure is usually needed?

1. AIsolation only after the patient has gone home
2. BDroplet precautions until 24 hours of effective antibiotics have been given
3. CAirborne precautions with a negative-pressure room for the whole hospital stay
4. DNo precautions, because it is not contagious

A patient with heart failure takes furosemide once a day. When is the best time to take it?

1. AJust before the evening meal, with a large drink
2. BIn the morning, to avoid needing the toilet at night
3. CAt bedtime, so the effect lasts through the night
4. DWhenever the ankles look swollen, on those days only

A one-way speaking valve is fitted to a patient's tracheostomy tube while the cuff is still inflated. What is the danger?

1. AThe patient will speak too loudly
2. BThere is no danger, as the valve works with any cuff
3. CThe valve will humidify the air too much
4. DThe patient cannot breathe out and may suffocate

Quale punteggio della Glasgow Coma Scale indica di solito che un paziente potrebbe non essere in grado di proteggere le proprie vie aeree?

1. A15
2. B13 o inferiore
3. C11 o superiore
4. D8 o inferiore

Un paziente con ipertensione endocranica necessita di aspirazione endotracheale. Quale approccio è più appropriato?

1. AAspirare ogni 15 minuti di routine, anche senza secrezioni
2. BAspirare per almeno 30 secondi per eliminare tutte le secrezioni in una volta
3. CFar sdraiare il paziente con la testa ruotata durante l'aspirazione
4. DPre-ossigenare, tenere ogni passaggio breve e limitare il numero di passaggi

Un paziente con emorragia GI superiore acuta ha un'emoglobina normale all'arrivo. Perché può essere fuorviante?

1. ACala solo dopo che gli spostamenti di liquidi o i liquidi EV diluiscono il sangue
2. BL'emoglobina aumenta sempre all'inizio dopo qualsiasi perdita di sangue
3. CL'emoglobina cala solo dopo un'intera settimana di sanguinamento continuo
4. DL'emoglobina non è influenzata dal sanguinamento intestinale

Durante un'infusione EV di vincristina attraverso una cannula periferica, il paziente riferisce bruciore e il sito è gonfio. Che cosa deve fare per prima cosa l'infermiere?

1. AProseguire l'infusione più lentamente e applicare del ghiaccio sul sito
2. BLavare la cannula con soluzione fisiologica per spingere il farmaco residuo nella vena
3. CRimuovere subito la cannula e massaggiare l'area per diffondere il farmaco
4. DInterrompere l'infusione, lasciare la cannula per aspirare, seguire la procedura