Priorità e delega in stile NCLEX: pacchetto last-minute

A patient with a valid do-not-resuscitate order (DNR; called DNACPR in the UK) stops breathing and has no pulse. What should the nurse do?

1. AStart chest compressions but not rescue breaths
2. BStart CPR and stop when the family arrives
3. CCall the cardiac arrest team and let them decide
4. DFollow the DNR order and do not start CPR

Un paziente con emorragia digestiva alta ha una frequenza cardiaca di 128/min e una pressione arteriosa di 84/50 mmHg. Tutti questi interventi sono prescritti. Quale avvia per primo l'infermiere?

1. ALiquidi o sangue per via endovenosa attraverso cannule di grosso calibro
2. BPrenotare l'endoscopia diagnostica per la mattina seguente
3. CCompresse di ferro per via orale
4. DUn'infusione endovenosa di inibitore di pompa protonica

When should a nurse call the rapid response team?

1. AOnly after a patient has had a cardiac or respiratory arrest on the ward
2. BOnly when the patient’s family makes a complaint
3. CWhen a patient shows an acute decline, such as new confusion or a sharp change in vital signs
4. DOnly when the provider has written an order for a rapid response call in the chart

A patient after heart surgery has temporary epicardial pacing wires. Why do staff take special care with electrical safety?

1. ASmall currents can travel along the wires straight to the heart and cause arrhythmias
2. BPacing wires can only carry current coming from the pacemaker box itself
3. CThe wires make the patient immune to electric shock
4. DElectrical safety only matters for patients who have permanent implanted pacemakers

A patient without symptoms has a fasting plasma glucose of 132 mg/dL (7,3 mmol/L) on Monday and 138 mg/dL (7,7 mmol/L) on Thursday. What does this show?

1. AThe results show reactive hypoglycemia
2. BThe results show prediabetes only
3. CThe results are within the normal fasting range
4. DThe results meet the criteria for diabetes

Il livello valle di vancomicina di un paziente è 28 mcg/mL; l'obiettivo fissato dal prescrittore è 15–20 mcg/mL. La dose successiva è dovuta ora. Qual è la migliore azione?

1. ASomministrare la dose come programmato e ricontrollare il valle tra una settimana
2. BSomministrare una dose doppia per finire prima il ciclo
3. CSospendere la dose, informare il prescrittore e controllare la funzione renale
4. DSomministrare la dose in un tempo più breve per ridurre l'esposizione

A rising serum creatinine most often indicates:

1. ADehydration of the skin only
2. BIncreased muscle strength
3. CReduced kidney function
4. DImproved liver function

Which feature suggests moisture-associated skin damage rather than a pressure ulcer?

1. AA deep wound over the sacrum with exposed bone and a dark base
2. BDiffuse, superficial redness in a skin fold, not over a bony prominence
3. CA round area of necrosis over the heel
4. DNon-blanching redness directly over the hip bone after lying on one side

Which ECG pattern is typical of acute pericarditis?

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

Un paziente in terapia con bisoprololo e diltiazem ha vertigini, frequenza cardiaca 38/min e PA 82/50 mmHg. Qual è la prima risposta più appropriata?

1. ASomministrare in anticipo le dosi successive di entrambi i farmaci per mantenere stabile la frequenza
2. BRegistrare i parametri e ricontrollarli dopo quattro ore
3. CChiedere aiuto urgente, valutare con ABCDE e collegare un monitor cardiaco
4. DFar camminare il paziente nel reparto per aumentare la frequenza cardiaca

When the nurse squeezes the trapezius muscle, the patient brings a hand up above the collarbone towards the stimulus. Which GCS motor score is this?

1. A3, abnormal flexion
2. B5, localises to pain
3. C4, withdraws from pain
4. D6, obeys commands

A nurse teaches foot care to a patient with diabetic neuropathy. Which statement shows a need for further teaching?

1. A"I will check my feet every day, using a mirror for the soles."
2. B"I will check that the bath water is not too hot using my elbow."
3. C"I will wear socks and shoes that fit well and do not rub."
4. D"I will buy corn plasters from the pharmacy for my corn."

Which advice helps prevent dumping syndrome after gastrectomy?

1. AThree large meals a day with plenty of sweet drinks with each meal
2. BSmall, frequent meals low in simple sugars, with fluids between meals
3. CA high-sugar diet with fruit juice to keep energy levels up
4. DSit upright and walk briskly straight after every meal

On day 5 after bowel resection, a patient has a fever, tachycardia and worsening abdominal pain, and the drain contains brown, faeculent fluid. What is most likely?

1. AA normal day 5 recovery
2. BPostoperative constipation
3. CA urinary tract infection
4. DAn anastomotic leak