ورقة عمل تحديد الأولويات والتفويض مع الإجابات

Which pain scale is designed for infants and young children who cannot describe their pain?

1. AThe FLACC scale
2. BThe Braden Scale
3. CThe Morse Fall Scale
4. DThe Glasgow Coma Scale

أي مهمة ينبغي أن تحتفظ بها الممرضة المسجلة بدلًا من تفويضها إلى مساعد غير مرخّص؟

1. Aالتقييم الأولي لمريض أُدخل حديثًا
2. Bقياس المتناول والمطروح وتسجيلهما
3. Cمساعدة مريض مستقر على المشي إلى الحمام والعودة
4. Dاستحمام مريض مستقر

Which finding in an infant is a sign of breathing difficulty?

1. AA strong cry
2. BPink, warm hands and feet
3. CNasal flaring
4. DWet diapers every few hours

A nurse teaches a patient with COPD pursed-lip breathing. Which statement shows a need for further teaching?

1. A“I will breathe in through my mouth and out quickly through my nose.”
2. B“I will make my breath out about twice as long as my breath in.”
3. C“I will breathe out slowly through pursed lips.”
4. D“I will breathe in slowly through my nose.”

A patient with heart failure gained 2 kg (about 4 lb) since yesterday and is more breathless when lying down. What should the nurse do first?

1. AEncourage extra fluids to correct the weight change
2. BLay the patient flat to help them breathe more easily
3. CRecord the weight on the chart and recheck it at the next weekly weigh-in
4. DAssess the lungs, oxygen saturation and swelling, then inform the provider

A nurse cannot read part of a medication order. What should the nurse do?

1. AAsk another nurse to guess what the order most likely says, then give it
2. BGive the usual dose of the drug the nurse thinks was meant
3. CSkip the drug and not tell anyone until the next ward round
4. DContact the prescriber to clarify the order before giving the drug

A child is admitted with a suspected Wilms tumor (nephroblastoma). Which instruction is most important for all staff?

1. ADo not palpate the abdomen
2. BMeasure abdominal girth by pressing firmly
3. CGive a warm bath with abdominal massage
4. DEncourage the child to play contact sports

A patient taking an SSRI is also given tramadol. A few hours later the patient is agitated, sweating and has a fever, jerking muscles and brisk reflexes. What is the most likely cause?

1. AOpioid withdrawal
2. BNeuroleptic malignant syndrome
3. CSerotonin syndrome
4. DAn anxiety attack