Priorità e delega in stile NCLEX: pacchetto last-minute

A patient has a serum potassium of 6,8 mEq/L. Which action comes first?

1. AGive the patient’s scheduled potassium supplement
2. BRecheck the level next week
3. CPlace the patient on a cardiac monitor
4. DEncourage foods high in potassium

Quale reperto del paziente è inatteso e richiede un intervento dopo una resezione transuretrale della prostata con irrigazione vescicale continua?

1. AStimolo a urinare nonostante il catetere
2. BLievi spasmi vescicali che si attenuano con l'antispastico prescritto
3. CUrina rosa chiaro che diventa più limpida nel corso della giornata
4. DUrina rosso vivo con coaguli e flusso ridotto dal catetere

A patient has highly contagious viral conjunctivitis. Which teaching is most important?

1. AWear a surgical mask whenever someone else is in the room
2. BKeep using the same contact lenses to protect the eyes
3. CRub the eyes gently to remove the discharge
4. DWash hands often and do not share towels, pillows or eye drops

Quale azione di un'infermiera dimostra che si seguono i cinque momenti per l'igiene delle mani?

1. ASi pulisce le mani solo all'inizio e alla fine del turno
2. BSi pulisce le mani dopo aver toccato la sponda del letto
3. CSi pulisce le mani solo quando sembrano sporche
4. DIndossa gli stessi guanti tra due pazienti

A pregnant woman's blood type is O Rh-negative, and her antibody screen (indirect Coombs test) is negative. What is usually offered at about 28 weeks?

1. AAn IV dose of vitamin K given for the fetus
2. BAnti-D immunoglobulin (Rho(D) immune globulin)
3. CA transfusion of group O Rh-positive red cells
4. DDaily oral iron and folic acid supplements only

A patient with thalassemia major has received regular red cell transfusions for years. The ferritin is now very high. What does this most likely show, and what treatment is used?

1. AIron overload, treated with iron chelation therapy
2. BLiver failure, treated with a liver transplant at once
3. CIron deficiency, treated with IV iron supplements
4. DAcute infection, treated with broad-spectrum antibiotics

A nurse finds a patient lying on the floor beside the bed. What should be done first?

1. AComplete the incident report form
2. BCheck the patient for injuries before moving them
3. CLift the patient straight back into bed so they are comfortable
4. DPhone the patient's family

Several hours after thyroid surgery, a patient has increasing neck swelling, stridor and difficulty breathing. What is most likely?

1. AHypocalcaemia from parathyroid damage
2. BA haematoma compressing the airway
3. CNormal postoperative swelling
4. DA thyroid storm

A patient on home oxygen has dry, sore lips. Which product is safest to use?

1. AAn oil-based balm
2. BA water-based lubricant
3. CAn alcohol-based gel
4. DPetroleum jelly

The stump of a recent below-knee amputation suddenly bleeds heavily through the dressing. What should the nurse do first?

1. AApply firm direct pressure and call for urgent surgical help
2. BApply a warm compress to the stump
3. CEncourage the patient to walk on crutches to ease the pressure
4. DRemove all the dressings and wait for the bleeding to stop by itself

Which picture fits Brown-Séquard syndrome?

1. ALoss of all feeling but normal movement on both sides
2. BWeakness of both arms with normal strength in the legs
3. CParalysis of both legs, with normal sensation everywhere in the body
4. DWeakness on the same side and loss of pain on the opposite side

A patient arrives five hours after the onset of a stroke. A CT angiogram shows a blockage of a large artery in the brain. What is the most appropriate next step?

1. AStart IV alteplase immediately without further imaging
2. BNo treatment, because the time for any reperfusion has passed
3. CGive aspirin and plan a review on the ward tomorrow
4. DUrgent referral for assessment for mechanical thrombectomy

How should pancreatic enzyme replacement capsules usually be taken?

1. AOne hour after meals, on an empty stomach
2. BOnly on days with abdominal pain
3. CWith every meal and snack
4. DOnce a day at bedtime

On the morning of elective hip surgery, a patient says she took her usual warfarin last night despite being told to stop. What should the nurse do?

1. AInform the surgical and anaesthetic teams, who will check the INR
2. BGive a double dose of vitamin K by mouth without waiting for a prescription
3. CProceed with the usual checklist and say nothing
4. DTell her the surgery must be cancelled for a month