Priorità e delega in stile NCLEX: pacchetto last-minute

An Rh-negative mother has just given birth to an Rh-positive baby. What does the nurse expect to give the mother?

1. AVitamin K to the mother
2. BRh immunoglobulin within 72 hours
3. CNo treatment is needed
4. DA dose of the hepatitis B vaccine instead

A patient in acute mania paces constantly, has lost weight and will not sit down to eat. Which intervention is most helpful?

1. ALeave meals in the room and let the patient eat whenever and whatever they choose
2. BInsist that the patient sits at the table until the meal is finished
3. CWait until the mania settles before worrying about nutrition
4. DOffer high-calorie finger foods and drinks the patient can take while moving

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

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

A nurse teaches a patient going home with an MRSA wound infection. Which statement shows a need for further teaching?

1. A“I will keep the wound covered with a clean, dry dressing.”
2. B“I will put used dressings in a sealed bag before throwing them out.”
3. C“I can share towels with my family if I wash them every week.”
4. D“I will wash my hands after touching my dressing.”

A patient with type 2 diabetes starts prednisone each morning. When is the glucose most likely to be highest?

1. AAt midnight only
2. BIn the afternoon and evening
3. CThe glucose will not change
4. DIn the early morning, before the dose

Weeks after neck surgery, a patient has muscle cramps and tingling. Calcium is low, phosphate is high and parathyroid hormone (PTH) is low. Which condition fits best?

1. AHypoparathyroidism
2. BChronic kidney disease
3. CVitamin D toxicity
4. DPrimary hyperparathyroidism

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

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

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

1. ATachicardia, ipotensione e polso periferico debole e filiforme
2. BCute fredda e pallida
3. CPressione venosa giugulare aumentata e crepitii polmonari
4. DDiuresi ridotta

Quale esame di laboratorio si usa per regolare un'infusione di eparina non frazionata?

1. ALivello di fibrinogeno sierico
2. BLivello di D-dimero
3. CINR (rapporto internazionale normalizzato)
4. DaPTT (o livello di anti-Xa)

Un paziente che ha ricevuto uno stent coronarico dopo un NSTEMI chiede perché prende due antiaggreganti. Quale risposta è più accurata?

1. AIl secondo farmaco scioglie il coagulo che ha causato l'infarto iniziale
2. BSi bloccano due vie, proteggendo lo stent, ma il rischio di sanguinamento aumenta
3. CI due farmaci abbassano il colesterolo, così non si formano nuove ostruzioni
4. DIl secondo farmaco protegge la mucosa gastrica dall'aspirina

A patient uses a continuous glucose monitor. Which statement is correct?

1. AIt reads glucose in fluid under the skin, a little behind blood glucose
2. BIt makes finger-prick checks unnecessary in every situation
3. CIt measures glucose directly in the blood every second of the day
4. DIt works by giving small doses of insulin automatically

A patient arrives five hours after the onset of a stroke. A CT angiogram shows a blockage of a large artery in the brain. What is the most appropriate next step?

1. AStart IV alteplase immediately without further imaging
2. BUrgent referral for assessment for mechanical thrombectomy
3. CNo treatment, because the time for any reperfusion has passed
4. DGive aspirin and plan a review on the ward tomorrow

Why is the Lund and Browder chart preferred to the rule of nines for children?

1. AIt is faster to use than any other method of estimation
2. BIt counts superficial burns as well
3. CIt adjusts for body proportions that change with age
4. DIt is used only for burns of the hands

Dieci giorni dopo la chemioterapia, un paziente ha una temperatura di 37,6 °C ma si sente infreddolito e poco bene, con polso 112/min e PA 95/60 mmHg. Qual è l'azione corretta?

1. ATrattare come possibile sepsi neutropenica: antibiotici EV entro un'ora
2. BAttendere la conta dei neutrofili prima di decidere qualsiasi trattamento
3. CRassicurare il paziente, perché la temperatura è ancora sotto i 38 °C
4. DSomministrare paracetamolo e ricontrollare la temperatura dopo quattro ore