Priorità e delega in stile NCLEX: pacchetto last-minute

A patient is admitted with diabetic ketoacidosis. Which prescribed treatment is usually started first?

1. AIV isotonic fluid such as 0,9% sodium chloride
2. BSubcutaneous long-acting insulin only, given once
3. CA high-carbohydrate meal
4. DOral potassium tablets

Un paziente con trauma cranico e frattura della gamba è monitorato. Quale reperto è la priorità?

1. AUna piccola escoriazione al gomito
2. BIl punteggio della Glasgow Coma Scale scende da 15 a 12
3. CDolore alla gamba 6/10 nonostante l'ultima dose di analgesico
4. DIl paziente chiede qualcosa da mangiare

A nurse gives part of a dose of an opioid from a vial and must discard the rest. What is correct?

1. AReturn the rest to the patient’s medication drawer
2. BDiscard it in front of a second licensed (registered) nurse, who witnesses and documents it
3. CKeep the rest for the patient’s next dose
4. DDiscard it alone in the sink and document the amount wasted later in the shift

Several patients arrive with suspected inhalational anthrax after a deliberate release. Which precautions are needed for their care?

1. ADroplet precautions with surgical masks
2. BStandard precautions, because it is not spread from person to person
3. CContact precautions with gowns and gloves
4. DAirborne precautions in negative-pressure rooms, because spores are inhaled

For most hospitalized adults with diabetes who are critically ill, which glucose target range is commonly recommended?

1. AAbout 60–80 mg/dL (3,3–4,4 mmol/L)
2. BAbout 250–300 mg/dL (13,9–16,7 mmol/L)
3. CAbout 300–350 mg/dL (16,7–19,4 mmol/L)
4. DAbout 140–180 mg/dL (7,8–10 mmol/L)

The nurse prepares a patient for a 2-hour oral glucose tolerance test tomorrow morning. Which statement shows a need for further teaching?

1. A"I'll stay seated during the test if I can"
2. B"I'll fast overnight but can drink plain water"
3. C"I'll avoid smoking until the test is over"
4. D"I can have a light breakfast before the test"

Which is a recognised risk factor for postoperative nausea and vomiting?

1. AA short operation under local anaesthetic
2. BBeing male
3. CUse of opioids after surgery
4. DBeing a smoker

Why might a patient with diabetes who takes a beta-blocker not notice hypoglycaemia early?

1. ABeta-blockers make the patient sleep through the night
2. BBeta-blockers can mask warning signs such as tremor and a fast heart rate
3. CBeta-blockers stop the liver from responding to insulin
4. DBeta-blockers raise blood glucose, so true hypoglycaemia cannot happen at all

Before the first treatment dose of a low-molecular-weight heparin for a PE, what does the nurse need to make sure of?

1. AAn accurate, recent body weight is recorded
2. BThe patient has fasted for 12 hours
3. CThe patient's blood glucose is above 10 mmol/L (180 mg/dL)
4. DA chest drain is in place

Dopo un intervento all'anca, un paziente diventa improvvisamente dispnoico e ansioso con frequenza cardiaca 124/min, SpO₂ 86% in aria ambiente e dolore acuto con il respiro. Il torace all'auscultazione è pulito. Che cosa deve fare per prima cosa l'infermiere?

1. AFar sdraiare il paziente e sollevare entrambe le gambe su cuscini
2. BSomministrare un sedativo per l'ansia e ricontrollare dopo un'ora
3. CSomministrare ossigeno, mettere il paziente seduto, chiedere una valutazione urgente e restare con lui
4. DFar camminare il paziente nel reparto per migliorare la respirazione

Why should long-term steroid treatment not be stopped suddenly?

1. AStopping causes the blood glucose to fall sharply
2. BThe suppressed adrenal glands cannot make enough cortisol at once
3. CStopping suddenly makes the bones grow too quickly and then fracture
4. DThe steroids build up and become toxic after they are stopped

A patient with known back pain says they now cannot feel the skin between their legs and have not passed urine for 12 hours. What should happen?

1. AA routine physiotherapy appointment next week
2. BUrgent MRI and referral to the spinal surgeons
3. CAdvice to rest at home and take stronger painkillers
4. DA laxative and review in the clinic in a month

Which early symptoms suggest local anaesthetic systemic toxicity?

1. ATingling around the mouth, a metallic taste and tinnitus
2. BA red rash only at the injection site, with no other symptoms
3. CIncreased hunger and thirst over several hours, with a dry mouth
4. DMild itching of the feet the next day

Quattro pazienti sono in un reparto chirurgico. Quale paziente deve valutare per primo l'infermiere?

1. AQuattro ore dopo un intervento intestinale: polso 118/min, PA 90/55 mmHg
2. BGiorno 3 dopo l'intervento: chiede un lassativo per la stitichezza
3. CNeutropenico: temperatura normale un'ora fa, si sente bene
4. DIleostomia stabile: chiede aiuto per cambiare il sacchetto