Priorità e delega in stile NCLEX: pacchetto last-minute

The day after a total thyroidectomy, a patient reports tingling around the mouth and in the fingers. What should the nurse do first?

1. AEncourage deep breaths into a paper bag until it passes
2. BCheck for signs of low calcium and inform the provider
3. CReassure the patient that this is normal after neck surgery
4. DGive the patient’s routine oral iron supplement early

Durante un'alimentazione enterale continua con sondino, un paziente comincia all'improvviso a tossire, ha affanno e la SpO₂ scende. Qual è la prima azione dell'infermiere?

1. ALavare il sondino con 50 mL di acqua, poi continuare l'alimentazione come prima
2. BMettere il paziente disteso perché riposi
3. CAumentare la velocità dell'alimentazione perché finisca prima
4. DSospendere l'alimentazione, mettere il paziente seduto e valutare la respirazione

A patient has patient-controlled analgesia (PCA). A family member presses the button while the patient sleeps. What should the nurse explain?

1. AOnly the patient should press it, because this keeps the system safe
2. BThe pump will always stop any overdose
3. CPressing it while the patient sleeps prevents the pain from getting worse later
4. DFamily can press it as long as they count the presses

A nurse teaches a patient with neutropenia about preventing infection at home. Which statement shows a need for further teaching?

1. A“I will avoid crowds and people who have colds.”
2. B“I can clean the cat’s litter box if I wear a face mask.”
3. C“I will wash my hands often and ask visitors to do the same.”
4. D“I will check my temperature and call if I have a fever.”

Un paziente in terapia con fenitoina ha un livello di 28 mcg/mL (intervallo abituale circa 10–20 mcg/mL). Quali reperti si aspetterebbe l'infermiere?

1. AOnde T alte e appuntite
2. BSolo comportamento iperattivo e insonnia
3. CNistagmo, andatura instabile e linguaggio impastato
4. DFame e aumento di peso

A patient on warfarin with an INR of 3,6 fell and hit their head an hour ago. They now report a worsening headache and drowsiness. What is the priority?

1. AGive acetaminophen (paracetamol) and recheck the INR tomorrow
2. BReport urgently for imaging and possible reversal
3. CEncourage rest in a dark room to settle the pain
4. DHold warfarin for one dose and observe at home

After a total hip replacement through a posterior approach, which movement should the patient usually avoid in the early weeks?

1. ABending the hip beyond 90 degrees or crossing the legs
2. BLying on their back
3. CWalking short distances with a frame and a physiotherapist
4. DDoing gentle ankle exercises

Why can sepsis be missed in older adults?

1. ABlood tests are not useful in older people
2. BOlder adults cannot develop sepsis because their immune system is weaker
3. CThey may have no fever and present with confusion, falls or reduced mobility
4. DOlder adults always have a very high fever

Quale affermazione su un distanziatore per inalatore dosato è corretta?

1. AÈ progettato per essere usato con inalatori a polvere secca
2. BRende ogni erogazione del farmaco più forte del solito
3. CPermette di sospendere del tutto l'inalatore di steroide di mantenimento
4. DServe meno coordinazione e più farmaco raggiunge i polmoni

A patient with severe sepsis becomes increasingly breathless over 24 hours. SpO₂ stays low despite high-flow oxygen, and the chest X-ray shows bilateral infiltrates. The heart function is normal. Which condition is most likely?

1. ASpontaneous pneumothorax
2. BAn acute asthma attack
3. CAcute left ventricular failure after an MI
4. DAcute respiratory distress syndrome

After pressing the plunger of an insulin pen, what should the patient do?

1. AInject a second dose straight away to be sure
2. BPull the needle out at once and rub the site firmly
3. CLeave the needle on the pen for the next injection
4. DKeep the needle in the skin for about 10 seconds

Six weeks after a kidney transplant, a patient has a fever, tenderness over the graft, less urine and a rising creatinine. What is most likely?

1. AAcute rejection, needing urgent transplant team review
2. BA side effect of sun exposure
3. CDehydration that needs only more oral fluids and rest
4. DA normal finding as the kidney settles in

Which factor can precipitate hepatic encephalopathy in a patient with cirrhosis?

1. AConstipation
2. BA high fluid intake
3. CRegular gentle walking
4. DA low-salt diet

La cute attorno all'ileostomia di un paziente è rossa, escoriata ed essudante e il sacchetto perde spesso. Qual è la causa più probabile?

1. AIschemia della stomia, che richiede un intervento urgente
2. BOutput a contatto con la cute, spesso da un presidio mal adattato
3. CUn'allergia alle feci stesse, che richiede steroidi
4. DUna reazione normale che non richiede cambiamenti nell'assistenza