Priorità e delega in stile NCLEX: pacchetto last-minute

A nurse takes a telephone order from a provider. What must the nurse do?

1. AAsk the ward clerk to take the order on the nurse’s behalf instead
2. BWrite the order down and read it back to the provider to confirm it
3. CRemember the order and write it in the chart at the end of the shift
4. DCarry out the order first and ask the provider to confirm it later

A patient is admitted with inhalational anthrax. Which precautions are needed?

1. ADroplet precautions with a surgical mask for everyone who enters
2. BFull contact and droplet precautions for all staff and visitors on the unit
3. CStandard precautions, because it does not usually spread from person to person
4. DAirborne precautions in a negative-pressure room for the whole of the hospital stay

A nurse pours sterile saline into a bowl on a sterile field. Which technique is correct?

1. AHold the bottle with the label in the palm and pour without touching the bowl
2. BPour from below the level of the field to reduce splashing
3. CReach across the field to fill the bowl at the far side
4. DRest the lip of the bottle on the edge of the bowl so that the saline does not splash

During a power cut in a US hospital, a ventilator must stay powered. Where should it be plugged in?

1. AInto any white outlet in the room
2. BInto a red outlet connected to the emergency generator
3. CInto an extension cord from the corridor
4. DInto the outlet that is closest to the bed, whatever its color

Which blood collection practice helps prevent hemolysis of the sample?

1. ALeaving the tourniquet on for at least 3 minutes
2. BUsing the smallest needle available for every patient
3. CForcing blood quickly through a needle into the tube
4. DGently inverting the tubes instead of shaking them

Il potassio di un paziente è stato 3,4–3,6 mEq/L per mesi, e un singolo risultato di oggi è 5,4 mEq/L. Il paziente si sente bene e l'ECG è normale. Qual è il miglior passo successivo?

1. ASospendere tutti i farmaci abituali del paziente
2. BControllare come è stato prelevato il campione, valutare il paziente e ripetere l'esame
3. CIgnorare il risultato, perché il paziente si sente bene
4. DAvviare subito un legante del potassio senza altri controlli

A rising serum creatinine most often indicates:

1. AReduced kidney function
2. BIncreased muscle strength
3. CImproved liver function
4. DDehydration of the skin only

Why might a patient with diabetes who takes a beta-blocker not notice hypoglycaemia early?

1. ABeta-blockers can mask warning signs such as tremor and a fast heart rate
2. BBeta-blockers raise blood glucose, so true hypoglycaemia cannot happen at all
3. CBeta-blockers stop the liver from responding to insulin
4. DBeta-blockers make the patient sleep through the night

Quali vaccinazioni sono di solito raccomandate alle persone con BPCO?

1. ANessun vaccino, perché è noto che scatenano le riacutizzazioni
2. BUn vaccino BCG ogni cinque anni
3. CSolo un richiamo antitetanico annuale
4. DVaccinazione annuale contro l'influenza e contro lo pneumococco

A patient being treated for pulmonary TB repeatedly misses doses and stops when they feel better. Which strategy is most effective?

1. ADoubling the dose on the days the patient remembers to take it
2. BSwitching to a single drug to make it easier
3. CDirectly observed therapy with support for barriers to adherence
4. DStopping treatment, as it is clearly not working for this patient

Where is the zero point of an external ventricular drain usually levelled?

1. AAt the level of the umbilicus
2. BAt the top of the head
3. CAt the tragus of the ear
4. DAt the mid-axillary line of the chest

An older man was found on the floor after lying there for many hours. His urine is dark brown, and his creatine kinase is very high. What is the main kidney risk and the key treatment?

1. AA urinary infection, treated with oral antibiotics only
2. BAKI from rhabdomyolysis, treated with generous IV fluids
3. CHypothermia, treated with a fluid restriction
4. DA kidney stone, treated with strong pain relief

Which monitoring is especially important for a patient receiving parenteral nutrition?

1. APupil size and limb strength
2. BPeak flow and visual acuity
3. CBlood glucose and signs of line infection
4. DBowel sounds and stool colour only

A patient with suspected appendicitis says the pain suddenly eased, but an hour later has a temperature of 38,9 °C, a rigid abdomen and a pulse of 118/min. What does this suggest?

1. AThe appendicitis has settled by itself
2. BSimple constipation that needs a laxative
3. CA side effect of the analgesia given
4. DPerforation with peritonitis