Priorità e delega in stile NCLEX: pacchetto last-minute

One hour after a vaginal birth, the nurse finds a soft, boggy uterus and heavy bleeding. What is the first action?

1. AOffer a meal and fluids
2. BApply an ice pack to the perineum
3. CMassage the fundus
4. DEncourage the patient to rest quietly

A patient at 32 weeks of pregnancy feels dizzy and faint while lying flat on her back. What should the nurse do first?

1. ASit her upright with her head between her knees
2. BGive her a sugary drink and keep her flat
3. CTurn her onto her left side
4. DRaise her legs while she stays on her back

How are neuromuscular blocking drugs, such as vecuronium, safely stored?

1. ASeparate from other drugs, with a warning that they cause paralysis
2. BNext to common IV antibiotics so they are easy to find
3. CIn the general stock cupboard with the other IV drugs and no special labels
4. DMixed in the same bin as other high-use drugs

In START triage at a mass-casualty incident, a casualty cannot walk, breathes 20 times a minute, has a radial pulse and follows simple commands. Which category applies?

1. AGreen (minor)
2. BYellow (delayed)
3. CRed (immediate)
4. DBlack (expectant or dead)

A patient with pneumonia had a CRP of 180 mg/L on admission and 40 mg/L after 4 days of antibiotics. What does this most likely show?

1. AThe patient has developed a new infection
2. BThe infection has spread to another organ
3. CThe inflammation is settling with treatment
4. DThe antibiotic is causing liver damage

A patient's low calcium does not improve despite several days of calcium replacement. Which other electrolyte should be checked and corrected?

1. ASodium
2. BBicarbonate
3. CChloride
4. DMagnesium

Which advice is correct for a patient taking levothyroxine?

1. AStop taking it once the symptoms improve
2. BTake it with a large meal to avoid nausea and stomach upset
3. CTake it on an empty stomach, usually before breakfast
4. DTake it only on days when feeling tired

Quale insieme di reperti distingue meglio lo shock cardiogeno da quello ipovolemico?

1. APressione venosa giugulare aumentata e crepitii polmonari
2. BCute fredda e pallida
3. CDiuresi ridotta
4. DTachicardia, ipotensione e polso periferico debole e filiforme

A patient on nasal cannula oxygen breathes mainly through the mouth. What is the most accurate statement?

1. AThe flow must be increased to 15 L/min to make it work at all
2. BIt can still work, because oxygen collects in the nasopharynx
3. CThe cannula should be placed in the mouth
4. DIt has no effect at all in mouth breathers and must be stopped

A patient with a confirmed pulmonary embolism has BP 78/50 mmHg despite fluids, and the right ventricle is dilated on echocardiography. Which treatment is most likely?

1. AAn inhaled bronchodilator
2. BCompression stockings and bed rest
3. COral apixaban only, started next week
4. DSystemic thrombolysis

A patient taking a GLP-1 receptor agonist has severe, constant upper abdominal pain spreading to the back, with vomiting. What should the nurse suspect?

1. AA simple urinary tract infection
2. BNormal nausea from the drug
3. CAcute pancreatitis
4. DLow blood glucose

A patient who has taken prednisolone daily for years is vomiting and cannot keep tablets down. What should the nurse do?

1. AEscalate urgently for steroid by injection
2. BGive the next dose with a glass of milk
3. CGive the tablets again after every vomit
4. DOmit the steroid until the vomiting stops

Which presentation fits acute diverticulitis?

1. ACentral chest pain spreading to the left arm
2. BPainless jaundice with a palpable gallbladder
3. CRight upper abdominal pain after fatty meals
4. DLeft lower abdominal pain, fever and a raised CRP

Which preoperative task can a registered nurse usually delegate to a healthcare assistant (nursing assistant)?

1. AAssessing the patient's understanding of the surgery
2. BTeaching the patient how to use a PCA pump
3. CDeciding whether abnormal results need reporting
4. DRecording baseline vital signs