After North Macedonia knocked Italy out of the World Cup qualifiers and drew the first game with Italy in this qualifier, I would say that the first decisive game will be with North Macedonia 
If you think like this, then in the event of a victory over Italy, North Macedonia still has a game with England (which has already decided its issues), so if North Macedonia takes 6 points in these games, and Ukraine lose to Italy, then North Macedonia will take second place in the group. They definitely have something to fight for.
upd: Hmm... Looks like I'm wrong. By personal meetings, Ukraine will still be higher than North Macedonia.
If you think like this, then in the event of a victory over Italy, North Macedonia still has a game with England (which has already decided its issues), so if North Macedonia takes 6 points in these games, and Ukraine lose to Italy, then North Macedonia will take second place in the group. They definitely have something to fight for.
upd: Hmm... Looks like I'm wrong. By personal meetings, Ukraine will still be higher than North Macedonia.
Crossed my mind, yeah.. but it would really be shameful for the Italians.
They are a much better team, playing at home. If they don't win there, what can they hope for in Ukraine?
To be honest though - I feel that Italy's team is sub-par. I like their centre mid options (Barella and Tonali), but other than that it's far from Italy that we used to watch.