Priorità e delega in stile NCLEX: pacchetto last-minute

An arterial blood gas shows pH 7,28, PaCO₂ 40 mmHg (5,3 kPa) and HCO₃⁻ 16 mEq/L (mmol/L). How should the nurse interpret it?

1. AMetabolic alkalosis
2. BRespiratory alkalosis
3. CMetabolic acidosis
4. DRespiratory acidosis

A nurse returns to the station to find four messages. Which one is answered first?

1. AThe pharmacy asks when the next delivery should be scheduled
2. BA colleague asks to swap shifts with them next week because of a family wedding
3. CA family member wants an update on their father’s progress
4. DThe laboratory is calling with a critical potassium result of 2,6 mEq/L

Perché una penna per insulina non deve mai essere usata per più di un paziente, anche con un ago nuovo?

1. AOgni penna contiene una sola dose di insulina
2. BIl sangue può rifluire nella cartuccia e diffondere infezioni
3. CCondividere una penna cambia la dose erogata
4. DL'insulina nella penna scadrebbe più in fretta se condivisa

Who should mark the operative site before surgery?

1. AThe admitting clerk, using the information written on the consent form
2. BAny member of the operating room team after anesthesia starts
3. CThe patient, alone, using a marker pen at home on the night before surgery
4. DThe person who will perform the procedure, with the patient involved where possible

A patient with hyponatremia from SIADH starts tolvaptan. Why is the serum sodium checked frequently in the first day?

1. AThe drug causes severe hyperkalemia
2. BThe sodium always falls further
3. CThe sodium can rise too quickly
4. DThe drug lowers blood glucose sharply

A patient's results: sodium 140 mEq/L, chloride 100 mEq/L, bicarbonate 12 mEq/L. What is the anion gap, and what does it suggest?

1. A28 mEq/L, a high anion gap
2. B52 mEq/L, a very high anion gap
3. C12 mEq/L, a normal anion gap
4. D40 mEq/L, a high anion gap

Qual è il farmaco di prima linea nell'anafilassi?

1. AUn antistaminico orale come la cetirizina
2. BUn corticosteroide inalatorio
3. CAdrenalina intramuscolare
4. DParacetamolo endovena

A nurse teaches a patient with a new ileostomy. Which statement shows a need for further teaching?

1. A"I will drink extra fluids when it is hot."
2. B"My output will be firm and formed like before."
3. C"I will empty the bag when it is about a third to half full."
4. D"My stoma should look pink or red and moist."

Quali caratteristiche descrivono meglio un'ulcera arteriosa della gamba?

1. AUlcera indolore sotto l'avampiede con spesso callo attorno
2. BUlcera superficiale e umida sopra la caviglia interna con cute bruna
3. CUlcera essudante sulla tibia con edema improntabile della gamba
4. DUlcera dolorosa, pallida, a stampo sulle dita dei piedi con polsi del piede deboli

A patient with a confirmed pulmonary embolism has BP 78/50 mmHg despite fluids, and the right ventricle is dilated on echocardiography. Which treatment is most likely?

1. ASystemic thrombolysis
2. BOral apixaban only, started next week
3. CAn inhaled bronchodilator
4. DCompression stockings and bed rest

A patient receives phenytoin through a nasogastric tube along with continuous enteral feed. Which issue should the nurse know about?

1. AThe feed increases phenytoin levels and causes toxicity within hours
2. BPhenytoin makes the feed curdle, so the two must never be used in one patient
3. CThe feed can reduce phenytoin absorption, so the feed is often paused around the dose
4. DPhenytoin must be crushed and mixed into the feed bag

A haemodialysis patient missed their last two sessions. They are breathless, with crackles, and the potassium is 6,9 mmol/L. What is the priority?

1. AUrgent dialysis, with cardiac monitoring meanwhile
2. BLarge IV fluid boluses to improve the circulation
3. COral potassium supplements and rest
4. DA routine dialysis session at the next planned slot

Quale integratore a base di erbe viene comunemente chiesto prima di un intervento perché può aumentare il sanguinamento?

1. AGinkgo biloba
2. BCamomilla
3. CMirtillo rosso
4. DOlio di menta piperita

During burn resuscitation, a 70 kg adult's urine output has been 120 mL/h for 3 hours, and the face and limbs are very oedematous. What should the nurse do?

1. AIncrease the fluid rate to keep the output high
2. BDiscuss reducing the fluid rate with the team
3. CStop all IV fluids completely and remove the catheter
4. DGive a diuretic without discussing it