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

A patient with MRSA in a wound is on contact precautions. Which instruction to the nursing assistant is correct?

1. ANo special precautions are needed if the wound is covered with a dressing
2. BOnly wear gloves when touching the wound itself; skin and bedding are safe
3. CWear a gown and gloves for contact with the patient or the room, and use dedicated equipment
4. DWear a respirator mask in the room, because MRSA in a wound spreads through the air to others

Which instruction about using a standard walker is correct?

1. AWalk well ahead of the walker for balance
2. BCarry the walker and use it only when tired
3. CPush up from the walker to stand from a chair
4. DMove the walker forward, then step into it

An audit shows poor hand hygiene compliance on a ward. Which plan is most likely to improve it?

1. ARemoving all sinks so staff must use hand rub
2. BA single poster about hand hygiene placed in the staff room
3. CA combined approach with education, hand rub at every bedside, regular audits and feedback
4. DDisciplining staff who are seen not cleaning their hands, with no other change

A patient takes high-dose biotin supplements for hair and nails. Why should the nurse report this before blood tests?

1. ABiotin causes a true rise in blood glucose in all patients
2. BBiotin makes the blood clot in the tube before testing
3. CBiotin can distort some immunoassays, such as troponin or TSH
4. DBiotin lowers the hemoglobin by destroying the red cells

A patient in hyperosmolar hyperglycemic state has a glucose of 1,050 mg/dL (58 mmol/L), very dry mucous membranes and a fast pulse. Which treatment is usually the first priority?

1. AOral glucose-lowering tablets
2. BLarge-volume IV fluid replacement
3. CStrict fluid restriction
4. DAn IV bolus of sodium bicarbonate

What is the best way to protect the heels of a bed-bound patient from pressure damage?

1. ARest the heels on a rolled-up towel
2. BOffload the heels so they do not touch the mattress
3. CMassage the heels firmly several times a day to help circulation
4. DApply a tight bandage to the heels

Quale valutazione infermieristica aiuta meglio a rilevare un peggioramento precoce in un paziente dopo chirurgia maggiore?

1. ARilevazioni regolari complete dei parametri con un early warning score e l'analisi del loro andamento
2. BChiedere al paziente solo se si sente bene
3. CControllare la ferita solo alla dimissione
4. DMisurare la temperatura una volta al giorno

How is a patient usually positioned for a thoracentesis?

1. AProne with the arms by the sides
2. BFlat on the back with the legs raised
3. CLying on the affected side with the head down
4. DSitting upright and leaning forward over a table

A healthcare assistant (unlicensed assistive personnel) reports four observations. Which one needs the nurse's attention first?

1. AA patient after a PCI asking for a cup of tea
2. BA patient with COPD whose SpO₂ is 90% on 1 L/min, which is usual for him
3. CA patient with heart failure who is newly confused, with SpO₂ 89%
4. DA patient with a DVT whose leg is less swollen today

A woman who takes the combined contraceptive pill is starting carbamazepine. What should she be taught?

1. AShe should take both at the same time so they are absorbed together
2. BThere is no interaction between these two medicines
3. CCarbamazepine can make the pill less effective, so other contraception is needed
4. DThe pill makes carbamazepine toxic, so she must stop the pill

Un paziente con DKA sta migliorando: glicemia 9 mmol/L, chetoni 0,4 mmol/L, pH 7,36. Sta mangiando e bevendo. Come va sospesa l'insulina EV?

1. ASomministrare insulina sottocutanea con un pasto, poi interrompere l'EV dopo una sovrapposizione
2. BSomministrare insulina sottocutanea solo se la glicemia sale sopra 20 mmol/L
3. CInterrompere subito l'insulina EV e iniziare l'insulina sottocutanea domani
4. DSospendere tutta l'insulina, perché la chetoacidosi si è risolta del tutto

Which finding means a patient is usually ready to leave recovery for the ward?

1. APain score 9/10 and vomiting repeatedly
2. BSystolic BP falling steadily over the last hour, with a rising pulse rate
3. CStill drowsy and needing a jaw thrust to breathe
4. DAwake, with a clear airway, stable observations and controlled pain

Shortly after a spinal anaesthetic, a patient says their arms feel weak and it is hard to breathe, and the BP is falling. What is most likely?

1. AA normal spinal effect
2. BA high spinal block
3. CAn anxiety attack
4. DA post-dural puncture headache