Priorità e delega in stile NCLEX: pacchetto last-minute

A patient’s urinary catheter has drained no urine for two hours, and the lower abdomen is swollen. What should the nurse do first?

1. AGive a prescribed diuretic straight away
2. BRemove the catheter and wait for the patient to void
3. CCheck the tubing for kinks or obstruction
4. DEncourage the patient to drink more water

A patient with known abdominal aortic aneurysm suddenly has severe back pain, a pulsing mass in the abdomen and a falling blood pressure. What should the nurse do?

1. APalpate the mass firmly to check its size and spread
2. BGive an oral analgesic and reassess the patient in about one hour
3. CCall for emergency help at once and prepare for urgent surgery
4. DEncourage the patient to walk to ease the back pain

Which patient has the highest risk of a burn from a heating pad?

1. AA patient with diabetic peripheral neuropathy
2. BA healthy young adult with a strained muscle
3. CA patient recovering from a cold
4. DA patient with a sprained wrist who is fully alert

A nurse teaches a patient with neutropenia about preventing infection at home. Which statement shows a need for further teaching?

1. A“I will wash my hands often and ask visitors to do the same.”
2. B“I will check my temperature and call if I have a fever.”
3. C“I will avoid crowds and people who have colds.”
4. D“I can clean the cat’s litter box if I wear a face mask.”

When is a peak level for an IV aminoglycoside such as gentamicin usually drawn?

1. AExactly 24 hours after the first dose
2. BJust before the next dose is started
3. CAt any time convenient for the patient
4. DAbout 30 minutes after the infusion ends

A patient on lithium has had vomiting and diarrhea for 3 days and has been taking ibuprofen. They now have a coarse tremor and confusion. The lithium level is 2,2 mEq/L. What is the best interpretation and action?

1. AA low level; ask for the lithium dose to be raised
2. BA normal level; continue lithium as prescribed
3. CLithium toxicity; hold lithium and report urgently
4. DIbuprofen side effects only; give it with food

Why must levodopa for Parkinson's disease be given at the exact times prescribed in hospital?

1. AEarly doses cause severe low blood glucose and sweating attacks
2. BThe drug only works if taken at midnight
3. CLate doses cause dangerous high potassium
4. DDelays can quickly worsen rigidity, immobility and swallowing

A nurse teaches a patient with asthma about a new inhaled steroid "preventer". Which statement shows a need for further teaching?

1. A"I'll keep my reliever inhaler with me."
2. B"I will rinse my mouth after using it."
3. C"I will only use it when I'm wheezy."
4. D"I will use it every day even when I feel well."

A patient has just started an ACE inhibitor. Which blood tests are usually checked within the first one to two weeks?

1. AINR and platelet count
2. BPotassium and creatinine
3. CLiver enzymes and amylase
4. DTroponin and creatine kinase

A 74-year-old man with a known abdominal aortic aneurysm suddenly has severe back and abdominal pain. His heart rate is 128/min and BP 82/50 mmHg. What is the priority?

1. AEncourage him to walk to ease the back pain
2. BCall for emergency help and prepare for urgent vascular surgery
3. CArrange a routine outpatient ultrasound scan of the aneurysm
4. DGive oral analgesia and reassess the pain in an hour

Perché il potassio va monitorato attentamente quando si somministra insulina EV per una DKA?

1. AL'insulina degrada il potassio nel circolo sanguigno
2. BL'insulina non ha alcun effetto sul potassio nella DKA
3. CL'insulina fa trattenere potassio ai reni, perciò il livello aumenterà
4. DL'insulina sposta il potassio nelle cellule, perciò il livello può calare rapidamente

Dopo un intervento, una paziente con malattia di Graves ha una temperatura di 39,8 °C, una frequenza cardiaca di 160/min, agitazione e vomito. Quale insieme di trattamenti è più appropriato?

1. ARaffreddamento, un beta-bloccante, un farmaco antitiroideo, poi iodio e steroidi
2. BLevotiroxina e coperte calde per calmare i brividi
3. CRestrizione dei liquidi e un diuretico dell'ansa per trattare la tachicardia
4. DAspirina per la febbre e visita dal medico di famiglia entro una settimana

Why are accurate fluid balance charts kept after major surgery?

1. ATo detect dehydration, fluid overload or kidney problems early
2. BTo check how far the patient has walked and how often they get out of bed
3. CTo decide which meal the patient will have next
4. DTo record when visitors come and go

A patient with cirrhosis and ascites has a falling urine output and a rising creatinine. They have not received nephrotoxic drugs and are not dehydrated. Which complication is likely?

1. AUrinary tract infection
2. BNephrotic syndrome
3. CHepatorenal syndrome
4. DPolycystic kidney disease