Priorità e delega in stile NCLEX: pacchetto last-minute

Un infermiere riceve quattro chiamate contemporaneamente. A quale paziente va per primo?

1. AUn paziente il cui sistema di infusione suona per una sacca di liquidi di mantenimento terminata
2. BUn paziente che chiede un analgesico per un dolore 4/10
3. CUn paziente che chiede a che ora verrà il medico
4. DUn paziente che dice: "Non riesco a respirare."

A patient is going home on a new oral anticoagulant. There is only a short time for teaching. Which topic is most important?

1. AHow to choose comfortable walking shoes
2. BHow to cook low-fat meals
3. CWhich television programs help with relaxation
4. DSigns of bleeding and when to seek help

Un paziente desidera rifiutare un farmaco prescritto. Che cosa deve fare l'infermiere?

1. ARegistrare la dose come somministrata per evitare domande da parte dell'équipe
2. BNascondere il farmaco nel cibo o nella bevanda del paziente per essere certi che lo assuma
3. CIndagare il motivo, spiegare, rispettare una scelta competente e documentare
4. DSomministrarlo comunque, perché è stato prescritto

A patient given naloxone for an opioid overdose wakes up. An hour later, the patient is drowsy again with slow breathing. What is the likely reason?

1. AThe patient is now allergic to naloxone
2. BThe patient is simply tired after the event
3. CNaloxone wears off sooner than many opioids, so the opioid effect returns
4. DNaloxone itself causes slow breathing and drowsiness once it has been given

A patient on peritoneal dialysis notices that the drained fluid is cloudy and has abdominal pain. What should the nurse do?

1. ASend the fluid for cell count and culture and report it
2. BStop dialysis for a week and recheck the fluid later
3. CAdd more glucose to the next bag to clear the fluid
4. DRecord it as normal and continue the usual exchanges

A patient on IV gentamicin has a trough level above the target, and the creatinine has risen since yesterday. The next dose is due. What is the best action?

1. AGive half of the dose and document the reason for it
2. BHold the dose and report the results to the prescriber
3. CGive the dose with extra oral fluids to protect the kidneys
4. DGive the dose now and recheck the levels next week

L'addome di un paziente è rigido «a tavola» e il paziente resta immobile perché il movimento peggiora il dolore. Che cosa suggerisce?

1. AInfezione delle vie urinarie
2. BPeritonite
3. CDispepsia
4. DStitichezza

Why is hypokalaemia particularly dangerous in a patient taking digoxin?

1. ADigoxin raises potassium to dangerous levels when it is already low
2. BLow potassium increases the risk of digoxin toxicity
3. CLow potassium stops digoxin from being absorbed
4. DLow potassium makes digoxin work too slowly

Which ECG pattern is typical of acute pericarditis?

1. AA sawtooth baseline with a regular ventricular rate
2. BTall peaked T waves with a wide QRS
3. CST elevation only in leads II, III and aVF with Q waves
4. DWidespread saddle-shaped ST elevation with PR depression

Un paziente in recupero da un infarto è in ansia per il ritorno alla vita normale. Quale intervento sostiene meglio il recupero?

1. AConsiglio di sospendere le compresse quando ci si sente bene
2. BConsiglio di evitare per sempre qualsiasi esercizio
3. CConsiglio di riposare a letto per tre mesi
4. DInvio alla riabilitazione cardiologica

Why can a patient with an insulin pump develop DKA within hours if the pump stops working?

1. AThe pump gives long-acting insulin, which builds up and stops working all at once
2. BThe pump gives only rapid-acting insulin, so there is no long-acting reserve
3. CThe body becomes allergic to insulin when the pump stops
4. DThe battery in the pump releases chemicals into the blood

A patient with lung cancer is confused, dehydrated and constipated, with a corrected calcium of 3,4 mmol/L (about 13,6 mg/dL). What is usually the first treatment?

1. AOral calcium tablets
2. BIV calcium gluconate and vitamin D
3. CA fluid restriction
4. DIV fluids to rehydrate the patient

Which technique is correct when giving a prefilled low molecular weight heparin injection?

1. AExpel the air bubble first and inject into the deltoid muscle
2. BRub the site firmly afterwards to help absorption
3. CLeave the air bubble in and inject into a skin fold
4. DInject into a vein in the back of the hand

A patient who takes NSAIDs suddenly develops severe epigastric pain, a rigid abdomen and shoulder-tip pain. Which finding would most support the likely diagnosis?

1. AA raised serum lipase three times the upper limit
2. BFree air under the diaphragm on an erect chest X-ray
3. CFluid levels in the bladder on an ultrasound scan
4. DTall, peaked T waves on a 12-lead ECG