Priorità e delega in stile NCLEX: pacchetto last-minute

A patient has a serum potassium of 2,9 mEq/L. Which finding should the nurse expect?

1. ATall, peaked T waves and muscle twitching
2. BFlushed, warm skin and a slow heart rate
3. CMuscle weakness and U waves on the ECG
4. DA rise in urine output and thirst only

A patient is deteriorating quickly. The nurse has called the provider twice, but the provider has not come. What is the best action?

1. AActivate the rapid response team
2. BWait another hour and call the provider again
3. CAsk the patient’s family to call the provider
4. DDocument the concern and continue routine care

Quando un infermiere deve usare un estintore su un incendio?

1. ASolo se l'incendio è piccolo, l'allarme è stato dato e l'uscita è libera
2. BMai; solo i vigili del fuoco possono usare gli estintori
3. COgni volta che c'è fumo, anche se l'uscita è bloccata
4. DSempre, anche prima di aver dato l'allarme, per risparmiare tempo

A patient dies after a wrong-drug error, and the hospital carries out a root cause analysis. What is its main focus?

1. ADeciding whether to tell the family about the error
2. BFinding the system and process weaknesses that allowed the error
3. CEstimating the legal costs for the hospital
4. DIdentifying which staff member made the error and should be disciplined

A patient with an upper gastrointestinal bleed has a BUN of 48 mg/dL (urea 17 mmol/L) and a normal creatinine. What is the most likely explanation?

1. ASkeletal muscle is breaking down because of the blood loss
2. BThe kidneys have suddenly lost most of their function
3. CThe liver has stopped making urea because of the bleeding
4. DDigested blood adds protein, which the liver turns into urea

Un paziente con iponatriemia cronica (sodio 118 mEq/L) è in trattamento. Perché il sodio deve essere aumentato lentamente?

1. APuò causare demielinizzazione osmotica, una grave lesione cerebrale
2. BUna correzione rapida causa ipokaliemia, che è l'unico rischio
3. CUna correzione rapida fa calare di nuovo il sodio ancora di più
4. DLa correzione lenta serve solo a ridurre i costi ospedalieri

A patient without diabetes is started on high-dose prednisolone. Why might capillary blood glucose be monitored?

1. ASteroids can raise the blood glucose
2. BSteroids make glucose meters inaccurate
3. CSteroids destroy the pancreas
4. DSteroids always cause hypoglycaemia

A patient has sudden, severe "tearing" chest pain going through to the back and a large difference in blood pressure between the arms. What should be suspected?

1. AAortic dissection
2. BStable angina
3. CGastro-oesophageal reflux
4. DPericarditis

A patient has chest pain at rest in the early morning with brief ST elevation that resolves. Coronary arteries are later found to be clear. Which condition is most likely?

1. AVasospastic (Prinzmetal) angina
2. BAcute pericarditis
3. CAortic stenosis
4. DStable exertional angina from a fixed plaque

A nurse looked after a patient for a shift before smear-positive pulmonary TB was diagnosed, without wearing a respirator. What should happen?

1. AReport it so occupational health can arrange follow-up screening
2. BTake no action, as healthcare workers are immune to TB
3. CStay off work for six months in case symptoms develop
4. DStart a full six-month course of TB drugs at once without any tests

Quale quadro elettrolitico è tipico della malattia di Addison?

1. ASodio basso e potassio alto
2. BSodio alto e potassio basso
3. CCalcio alto e fosfato basso
4. DPotassio basso e glicemia bassa

Three days after a stroke, a patient with dysphagia on a modified diet has a temperature of 38,2 °C (100,8 °F), a respiratory rate of 24/min and crackles at the right lung base. What should the nurse do?

1. ARecord the findings and recheck them at the next routine observation
2. BSuspect aspiration pneumonia, stop oral intake and escalate for review
3. CGive paracetamol (acetaminophen) and continue the modified diet as before
4. DEncourage more fluids by mouth to treat the fever

Why is a gastrostomy tube with an internal bumper usually advanced and rotated regularly once the tract has healed?

1. ATo check that the patient is still hungry
2. BTo stop the inner bumper becoming buried in the stomach wall
3. CTo remove any feed left in the stomach
4. DTo make the tube longer as the patient grows or gains weight

A patient has had a large terminal ileum resection for Crohn's disease. Which long-term problems should the nurse anticipate?

1. AExcess vitamin D and calcium kidney stones in the first year
2. BInsulin deficiency and high blood glucose from loss of the islets
3. CIron overload and constipation
4. DVitamin B₁₂ deficiency and bile-acid diarrhoea