Priorità e delega in stile NCLEX: pacchetto last-minute

An older patient becomes confused over a few hours, with attention that comes and goes. What does this suggest?

1. ADelirium, which needs the cause found quickly
2. BA personality change that is permanent and expected
3. CLong-standing dementia that is expected
4. DNormal aging that needs no action

Before surgery, a nurse is asked to witness a patient’s consent. The patient was given a sedative 30 minutes ago. What should the nurse do?

1. AWitness it quickly before the sedative takes full effect
2. BNot witness the consent and inform the surgeon
3. CAsk a family member to sign on the patient’s behalf
4. DWitness it and write “sedated” beside the signature

When walking with axillary crutches, where should the patient’s weight be taken?

1. AOn the armpits, resting on the crutch tops
2. BOn the hands, with the crutch tops a few finger widths below the armpits
3. COn the shoulders, with the crutches pressed upward
4. DOn the elbows, kept bent at a right angle with the crutch tops tucked under the arms

A patient takes medicines prescribed by several providers. Which advice best reduces the risk of medication errors at home?

1. AOnly tell each provider about the drugs they prescribed
2. BKeep one up-to-date list of all medicines and use one pharmacy where possible
3. CStop taking any medicine that seems to repeat another one, without asking anyone
4. DKeep each provider’s medicines in separate bags

On the first day after major surgery, a patient's white cell count is 12,5 × 10³/µL, with no fever or wound signs. What is the best interpretation?

1. AA sign of leukemia that needs bone marrow testing
2. BA common stress response to surgery that is monitored
3. CA laboratory error, since surgery lowers white cells
4. DDefinite wound infection that needs antibiotics now

A stable patient's hemoglobin has been 13–14 g/dL for days. Today's result is 8,2 g/dL, but the patient feels well, the vital signs are normal and there is no bleeding. What should the nurse suspect first?

1. AAcute bone marrow failure overnight
2. BSudden massive internal bleeding
3. CA sample taken from the wrong patient
4. DA normal day-to-day variation in Hb

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

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

Four call bells ring at the same time. Which patient should the nurse see first?

1. AA patient asking what time they will be discharged
2. BA patient who has just become breathless after starting an IV antibiotic
3. CA patient asking for pain relief for chronic back pain that they rate as 3/10
4. DA patient who needs help to go to the toilet and has rung twice

Un paziente ha un peptide natriuretico di tipo B (BNP o NT-proBNP) elevato. Che cosa riflette principalmente?

1. AStiramento e sovraccarico di pressione dei ventricoli
2. BInfiammazione del fegato da congestione
3. CDanno ischemico del muscolo cardiaco
4. DDanno al muscolo scheletrico dopo una caduta

Two days after a coronary stent, a patient on aspirin and ticagrelor has black, tarry stools and feels faint on standing. What should the nurse do?

1. ACheck vital signs, report urgently and anticipate a blood count
2. BStop both antiplatelet drugs permanently on the nurse's own decision
3. CGive a laxative and repeat the observations tomorrow
4. DReassure the patient that iron tablets cause black stools

A conscious patient with a glucose of 3,1 mmol/L (56 mg/dL) can swallow safely. Which is the best first treatment?

1. AA chocolate bar and a cup of tea with milk
2. BGlucose tablets or a small glass of fruit juice
3. CA glass of milk and two plain biscuits
4. DA dose of rapid-acting insulin with a sandwich

Un paziente con sospetto ictus arriva due ore dopo l'esordio. La glicemia capillare è 2,4 mmol/L (43 mg/dL). Che cosa deve avvenire ora?

1. ASomministrare subito la trombolisi senza altri controlli
2. BTrattare la glicemia bassa e rivalutare i segni neurologici
3. CIgnorare la glicemia, perché non è rilevante per la valutazione dell'ictus
4. DSomministrare insulina EV per proteggere le cellule cerebrali

Which statement correctly describes physical dependence on opioids?

1. AThe drug no longer has any side effects
2. BThe patient always craves the drug and misuses it despite harm
3. CWithdrawal occurs if the drug is stopped suddenly
4. DThe patient is allergic to opioids

Why is an SGLT2 inhibitor such as dapagliflozin usually withheld before surgery?

1. AIt interacts with all general anaesthetic gases and stops them working
2. BIt causes the surgical wound to bleed more
3. CIt makes the patient's potassium dangerously high
4. DIt raises the risk of ketoacidosis, even with near-normal glucose