Priorità e delega in stile NCLEX: pacchetto last-minute

An anxious patient is breathing very fast and has tingling fingers. The blood gas shows pH 7,51 and PaCO₂ 29 mmHg (3,9 kPa). What should the nurse do first?

1. AGive IV sodium bicarbonate as soon as it can be found
2. BEncourage the patient to breathe even faster
3. CGive oxygen at the highest flow and leave the room
4. DStay with the patient and coach slow, calm breathing

Which finding after a laparoscopic cholecystectomy is expected and needs only reassurance and comfort measures?

1. ARight shoulder pain from the gas used during surgery
2. BYellow skin with dark urine on the second day
3. CA heart rate of 125/min with a falling blood pressure
4. DIncreasing abdominal pain with a temperature of 39 °C

A patient in bed has a generalized tonic-clonic seizure. What should the nurse do?

1. AGive sips of water to keep the airway moist
2. BHold the arms and legs firmly to stop the movements
3. CPut a padded tongue blade between the teeth to protect the tongue from biting
4. DTurn the patient on their side and protect them from injury without restraining

During bedside handoff, the patient says, “I’m allergic to sulfa drugs,” but no allergy is recorded. What should the nurse do?

1. AClarify the reaction, update the allergy record and tell the prescriber
2. BTell the patient that sulfa drugs are always safe
3. CIgnore it, because the electronic record is more reliable than the patient’s memory
4. DWait until the patient is discharged to update the record

Un paziente con cirrosi ha un'albumina di 2,2 g/dL (22 g/L). Quale reperto è più probabilmente correlato?

1. APressione arteriosa alta
2. BEdema e ascite
3. CAumento della diuresi
4. DIperkaliemia

A patient started methimazole for hyperthyroidism 6 weeks ago and now has a fever and a severe sore throat. Which action is most important?

1. ACheck the TSH and double the dose if it is still low
2. BHold the drug and arrange an urgent white cell and neutrophil count
3. CGive the next dose and suggest warm salt-water gargles for comfort
4. DAdvise the patient to continue the drug and drink more fluid

An older adult has left lower abdominal pain, fever and a raised CRP. Which condition is most likely?

1. ABiliary colic
2. BGastric ulcer
3. CAppendicitis
4. DDiverticulitis

A patient admitted after a fall takes many regular medicines. Which safety step on admission helps prevent medication errors?

1. AStopping all regular medicines until the day the patient is discharged
2. BMedicines reconciliation against reliable sources, such as primary care records
3. CPrescribing only the medicines that the patient can remember taking
4. DDoubling the doses to make up for any missed while at home

Why is intravenous furosemide given slowly rather than as a rapid push of a large dose?

1. ARapid high doses can damage hearing
2. BRapid doses cause severe constipation
3. CSlow injection makes the urine output larger
4. DRapid doses cause the potassium level to rise

Dopo un intervento all'anca, un paziente diventa improvvisamente dispnoico e ansioso con frequenza cardiaca 124/min, SpO₂ 86% in aria ambiente e dolore acuto con il respiro. Il torace all'auscultazione è pulito. Che cosa deve fare per prima cosa l'infermiere?

1. AFar sdraiare il paziente e sollevare entrambe le gambe su cuscini
2. BSomministrare un sedativo per l'ansia e ricontrollare dopo un'ora
3. CFar camminare il paziente nel reparto per migliorare la respirazione
4. DSomministrare ossigeno, mettere il paziente seduto, chiedere una valutazione urgente e restare con lui

For which patient with migraine would the nurse question an order for sumatriptan?

1. AA patient with well-controlled hypothyroidism
2. BA patient with a history of angina
3. CA patient who also has asthma
4. DA patient with an allergy to penicillin

Un paziente con tumore del polmone e SIADH ha un sodio di 112 mmol/L e ha convulsioni. Qual è il trattamento più appropriato?

1. ASoluzione salina ipertonica, monitorata, con una velocità di aumento limitata
2. BGrandi volumi di acqua per bocca per aiutare a diluire l'urina
3. CCorrezione rapida a 140 mmol/L nelle prime sei ore
4. DGlucosio EV al 5% a velocità elevata finché le convulsioni non cessano

What is anticipatory nausea in chemotherapy?

1. ANausea that starts about a week after each cycle and lasts for days
2. BNausea triggered by reminders of treatment before it is given
3. CNausea caused by low blood glucose
4. DNausea caused only by the smell of food

On day 3 after laparoscopic cholecystectomy, a patient has abdominal pain, fever and mild jaundice, and green fluid is draining from the drain. What is most likely?

1. AUrinary retention
2. BA bile leak
3. CNormal post-operative drainage
4. DA wound haematoma