Priorità e delega in stile NCLEX: pacchetto last-minute

A patient uses patient-controlled analgesia (PCA) after surgery. Which statement by a family member shows a need for further teaching?

1. A“I will press the button for her while she is asleep so she stays comfortable.”
2. B“I will tell the nurse if she becomes very sleepy or hard to wake.”
3. C“The pump has limits set by the nurse so she cannot get too much at once.”
4. D“Only she should press the button when she needs pain relief.”

A patient on a cardiac monitor suddenly becomes unresponsive, and the monitor shows ventricular fibrillation. What is the priority once help has been called?

1. ACheck the blood potassium level before any shock is considered
2. BGive an oral antiarrhythmic tablet and recheck the rhythm in five minutes
3. CDefibrillate as soon as the defibrillator is available, with CPR until then
4. DRecord a full 12-lead ECG to confirm the rhythm before doing anything else at all

When should a nurse call the rapid response team?

1. AOnly when the provider has written an order for a rapid response call in the chart
2. BWhen a patient shows an acute decline, such as new confusion or a sharp change in vital signs
3. COnly when the patient’s family makes a complaint
4. DOnly after a patient has had a cardiac or respiratory arrest on the ward

A nurse teaches new parents how to cope with an infant’s crying. Which statement shows a need for further teaching?

1. A“I can call a friend or family member to help when I am tired.”
2. B“If he won’t stop crying, a quick shake will get his attention.”
3. C“If I get frustrated, I will put him safely in the crib and take a short break.”
4. D“I will check whether he is hungry, wet or too warm.”

How does normal pregnancy usually affect serum creatinine?

1. AIt stays exactly the same
2. BIt rises, because GFR falls
3. CIt rises with every week
4. DIt falls, because GFR rises

A patient with a large, fast-growing lymphoma will start chemotherapy tomorrow. Which plan best prevents tumor lysis syndrome?

1. AFluid restriction and a high-potassium diet before the treatment
2. BNo special measures, because the risk starts only after a week
3. CIV hydration, a uric acid-lowering drug and frequent electrolytes
4. DCalcium supplements and a high-phosphate diet during treatment

Why is an urgent brain scan needed before thrombolysis for a suspected stroke?

1. ATo rule out bleeding in the brain
2. BTo confirm the patient's age
3. CTo measure the size of the ventricles
4. DTo check for brain tumours only

Which action is most important in protecting a patient with severe neutropenia from infection?

1. AGiving routine intramuscular injections
2. BStrict hand hygiene by everyone who has contact with the patient
3. CKeeping fresh flowers and plants in the room to help the patient's mood
4. DTaking rectal temperatures regularly

A patient's blood pressure is 120/60 mmHg. What is the approximate mean arterial pressure?

1. A90 mmHg
2. B60 mmHg
3. C100 mmHg
4. D80 mmHg

A patient with a stab wound to the chest has a hole that sucks air with each breath. What is the immediate management?

1. APack the wound tightly with gauze pushed deep into the chest
2. BSeal it completely with tape on all four sides and leave it alone
3. CCover it with a vented chest seal or a dressing taped on three sides
4. DLeave it open and give a nebuliser

Come va riscaldato il liquido per dialisi peritoneale prima dell'uso?

1. AVa usato freddo, direttamente dal frigorifero
2. BIn un forno a microonde
3. CIn una ciotola di acqua calda del rubinetto
4. DIn un apposito scaldatore a calore secco

The day after a lumbar puncture, a patient has a headache that is severe when standing and almost gone when lying flat. Temperature and neck movement are normal. What is the most likely cause?

1. ABacterial meningitis from the procedure
2. BPost-dural puncture headache
3. CA subarachnoid haemorrhage
4. DA migraine triggered by stress

Which measure helps reduce the risk of delirium in an older surgical patient?

1. AKeeping the room dark during the day
2. BMaking sure they have their glasses and hearing aids
3. CMoving them to a new bed space each night to reduce boredom
4. DGiving a sleeping tablet every night

On the ward after surgery, a patient has a red, blistered area of skin under where the diathermy plate was. What should the nurse do?

1. AIgnore it because skin changes after surgery are normal and expected to fade
2. BTreat it as a possible burn, report it and complete an incident form
3. CApply a hot water bottle to improve the circulation
4. DWash it with alcohol and leave it uncovered