Priorità e delega in stile NCLEX: pacchetto last-minute

A patient arrives in the recovery room after general anesthesia. What does the nurse assess first?

1. AAirway patency and breathing
2. BThe surgical dressing and the drains
3. CThe pain score
4. DUrine output

After a head injury, a patient has clear fluid dripping from the nose. Which action should the nurse avoid?

1. AInserting a tube or suction catheter through the nose
2. BPlacing a loose gauze under the nose
3. CInforming the provider about the drainage
4. DChecking the fluid for glucose or a halo sign on gauze

A patient has a non-violent restraint. In most nursing policies, how often at minimum is it released for range of motion, toileting and skin care?

1. AOnly when the patient asks for it
2. BOnce every 12-hour shift
3. CAt least every 2 hours
4. DOnce a day, during the bath

A nurse teaches parents about using an infant car seat. Which statement shows a need for further teaching?

1. A“We will make sure the harness straps are snug against the baby’s chest.”
2. B“We will put the rear-facing seat in the front so we can see the baby.”
3. C“We will install the seat in the back seat, facing the rear.”
4. D“We will use the car seat for every trip, even short ones.”

In che modo il calcio gluconato endovenoso aiuta un paziente con iperkaliemia grave?

1. AAumenta l'eliminazione del potassio da parte dei reni
2. BStabilizza le membrane delle cellule cardiache senza abbassare il potassio
3. CLega il potassio nell'intestino così che venga eliminato con le feci
4. DSposta il potassio dal sangue alle cellule

A patient with a round face, central weight gain and purple stretch marks has a glucose of 210 mg/dL (11,7 mmol/L) and a potassium of 3,1 mEq/L. Which condition fits best?

1. ADiabetes insipidus
2. BHypothyroidism
3. CCushing syndrome
4. DAdrenal insufficiency

La crisi convulsiva di un paziente dura da più di cinque minuti. Che cosa significa?

1. AÈ normale e non richiede trattamento
2. BBisogna bloccare gli arti per fermare i movimenti
3. CVa trattata come stato epilettico e vanno somministrati farmaci d'emergenza
4. DBisogna mettere qualcosa in bocca per evitare il morso della lingua

A patient on metformin with reduced kidney function is due a CT scan with IV contrast. Why might metformin be withheld?

1. AMetformin reacts with the contrast to cause severe hyperglycaemia
2. BMetformin causes severe bleeding during scans
3. CMetformin makes the images blurry
4. DThere is a risk of lactic acidosis if kidney function worsens

Perché una semplice maschera facciale non va usata con un flusso di ossigeno inferiore a circa 5 L/min?

1. AL'elastico è troppo lento a flussi bassi
2. BA flussi bassi l'ossigeno non può essere umidificato
3. CLa maschera eroga troppo ossigeno a flussi bassi
4. DLa CO₂ espirata può accumularsi nella maschera ed essere reinalata

A patient declines enoxaparin for VTE prevention because it is made from pork, which conflicts with their beliefs. What is the best response?

1. AGive the injection anyway without explaining what the medicine is made from
2. BRespect the decision, inform the prescriber and discuss non-animal options
3. CDocument the refusal in the notes and take no further action at all
4. DTell the patient that refusal means they cannot have surgery

A patient has had a calcium oxalate kidney stone. Which advice best helps prevent another?

1. ACut all calcium out of the diet
2. BTake extra vitamin C supplements
3. CDrink only a little to avoid diluting the urine
4. DDrink plenty of fluid so the urine stays pale

The nurse has four endocrine patients. Which one needs to be seen first?

1. AA patient after thyroidectomy with mild pain on swallowing
2. BA patient with hyperthyroidism who is confused, with a temperature of 39,5 °C (103,1 °F)
3. CA patient with hypothyroidism who has been constipated for three days
4. DA patient with Graves' disease asking about radioactive iodine

How should pancreatic enzyme replacement capsules usually be taken?

1. AOne hour after meals, on an empty stomach
2. BWith every meal and snack
3. COnce a day at bedtime
4. DOnly on days with abdominal pain

After two days of large volumes of IV 5% glucose, a postoperative patient becomes confused with a headache. Sodium is 124 mmol/L. What is the likely cause?

1. AHypoglycaemia from the glucose
2. BNormal confusion after any anaesthetic
3. CHyponatraemia from hypotonic fluids
4. DHypernatraemia from too much salt