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. ARespiratory alkalosis
2. BRespiratory acidosis
3. CMetabolic acidosis
4. DMetabolic alkalosis

On an addiction unit, which patient should the nurse assess first?

1. AAnxious, with goose bumps, stomach cramps and loose stools
2. BAsking for an extra blanket and a hot drink
3. CDrowsy with pinpoint pupils and a respiratory rate of 7/min
4. DYawning, with a runny nose and dilated pupils

Quale rifiuto di medicazione va smaltito tra i rifiuti sanitari (a rischio biologico)?

1. AUna medicazione imbevuta di liquido proveniente da una ferita infetta
2. BUna salvietta di carta pulita usata per asciugarsi le mani
3. CUna medicazione non utilizzata, ancora sigillata, ma scaduta
4. DL'involucro esterno di carta di un kit di medicazione sterile

A nurse teaches parents about firearm safety at home. Which statement shows a need for further teaching?

1. A“We keep the gun loaded in the nightstand, and the children know not to touch it.”
2. B“We store the gun unloaded in a locked safe in the bedroom.”
3. C“We will ask other parents about guns before play dates.”
4. D“We keep all the ammunition locked away separately from the gun.”

A week after a splenectomy, a patient's platelet count is 650 × 10³/µL. What is the best interpretation?

1. AA sign of iron overload from the surgery and transfusion
2. BA sign of new leukemia that needs immediate chemotherapy
3. CAn expected rise after splenectomy that increases clot risk
4. DA laboratory error, because platelets fall after splenectomy

A patient admitted with heavy alcohol use and malnutrition has a glucose of 52 mg/dL (2,9 mmol/L) and low magnesium. Which prescribed treatment should be given before the IV glucose?

1. AIV thiamine
2. BIV insulin
3. COral iron
4. DIV potassium

In suspected sepsis, what should ideally be collected before the first dose of antibiotics, as long as it does not delay treatment?

1. AA 24-hour urine collection
2. BA stool sample for occult blood
3. CA fasting cholesterol level
4. DBlood cultures

During a blood transfusion, an older patient with heart failure becomes breathless with a rising blood pressure, raised JVP and crackles in the lungs. What is the most likely cause?

1. ATransfusion-associated circulatory overload
2. BA febrile non-haemolytic reaction
3. CTransfusion-related acute lung injury with hypotension
4. DAnaphylaxis

A patient is starting doxazosin, an alpha-blocker, for hypertension. Which advice is most important?

1. ATake it with a large glass of grapefruit juice to improve absorption
2. BStop it suddenly if the heart rate rises after the first few doses
3. CAvoid all potassium-containing foods
4. DTake the first dose at bedtime, as dizziness and fainting can occur

A patient with end-stage COPD has severe breathlessness at rest despite optimal treatment and wants comfort-focused care. Which measure is recognised to help?

1. AA low-dose opioid with a hand-held fan and calm positioning
2. BEncouraging long walks to build fitness
3. CHigh-flow oxygen at 15 L/min whatever the oxygen saturation is
4. DStopping all medicines, including inhalers

Perché i pazienti con MRC spesso assumono chelanti del fosfato ai pasti?

1. AAbbassano il potassio nel sangue legandolo nell'intestino
2. BAumentano l'assorbimento del fosfato dagli alimenti nell'intestino
3. CSostituiscono l'ormone mancante, l'eritropoietina
4. DLegano il fosfato degli alimenti che i reni non riescono a eliminare

During haemodialysis, a patient suddenly becomes breathless with chest pain, and air is seen in the line. What should the nurse do first?

1. ASpeed up the pump to clear the air into the patient
2. BSit the patient upright and give a drink of water
3. CContinue the session and recheck in 30 minutes
4. DClamp the lines and lay the patient left side down, head low

A patient on warfarin is booked for elective surgery with a high bleeding risk. What is usual practice?

1. ADouble the dose for a week so the blood is ready for surgery
2. BStop it about 5 days before and check the INR
3. CSwap to aspirin on the morning of surgery
4. DTake the usual dose on the morning of surgery

A patient's platelet count is 18 × 10⁹/L (18,000/µL). Which order should the nurse question?

1. AA soft diet with mouthwashes
2. BDaily full blood count
3. COral paracetamol for headache
4. DAn intramuscular injection