ورقة عمل تحديد الأولويات والتفويض مع الإجابات

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

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

Which statement belongs in the Background part of an SBAR report?

1. A“I would like you to see him within the next 15 minutes.”
2. B“I am calling about Mr Khan because his blood pressure has dropped.”
3. C“He was admitted three days ago with pneumonia and also has COPD.”
4. D“I think he may be developing sepsis.”

في التفويض، ماذا تعني "التوجيهات والتواصل الصحيحان"؟

1. Aإخبار المفوَّض إليه بأن يستخدم حكمه الخاص
2. Bكتابة المهمة في سجل المريض فقط
3. Cمطالبة المفوَّض إليه بالإبلاغ عن أي علامات غير معتادة في نهاية الوردية
4. Dتعليمات واضحة ومحددة: ماذا يفعل، ومتى، وما الذي يُبلَّغ عنه

A patient with diabetes is unresponsive and has a blood glucose of 40 mg/dL (2,2 mmol/L). What should the nurse do first?

1. AGive the scheduled dose of insulin
2. BGive IV dextrose or glucagon as prescribed
3. CPour orange juice into the patient’s mouth
4. DWait 15 minutes and recheck the glucose

بالغ مستقر لديه ألم بطني وعلامات حيوية طبيعية. سيحتاج إلى فحوص دم وتصوير مقطعي محوسب. أي مستوى ESI يناسب؟

1. Aالمستوى 4
2. Bالمستوى 5
3. Cالمستوى 3
4. Dالمستوى 1

On the first day after abdominal surgery, a patient has a temperature of 37,9 °C and reduced breath sounds at the lung bases. Which nursing action is most helpful?

1. AGive a cough suppressant so that the incision is not strained
2. BEncourage deep breathing, coughing and use of the incentive spirometer
3. CKeep the patient lying flat in bed to rest the incision fully
4. DRestrict oral fluids so that the lungs do not fill up with extra fluid

A patient is deteriorating quickly. The nurse has called the provider twice, but the provider has not come. What is the best action?

1. ADocument the concern and continue routine care
2. BActivate the rapid response team
3. CWait another hour and call the provider again
4. DAsk the patient’s family to call the provider

Which finding most suggests a tension pneumothorax rather than a simple pneumothorax?

1. ATrachea shifted away from the affected side, with low blood pressure
2. BMild breathlessness with reduced breath sounds on one side of the chest only
3. CSharp chest pain that is worse on deep breathing
4. DA small air leak seen on a routine chest X-ray