उत्तरों सहित प्राथमिकता निर्धारण और प्रत्यायोजन वर्कशीट

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

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

What is the normal range for arterial bicarbonate (HCO₃⁻)?

1. A80–100 mEq/L
2. B35–45 mEq/L
3. C22–26 mEq/L
4. D3.5–5.0 mEq/L

Which resting heart rate is normal for a newborn?

1. A60/min
2. B210/min
3. C140/min
4. D80/min

A patient is raising his voice, pacing and clenching his fists. What should the nurse do first?

1. ASpeak calmly, keep a safe distance and invite him to talk about what is wrong
2. BTurn away and ignore the behavior
3. CApply physical restraints at once
4. DStand very close to him and tell him firmly and loudly to sit down and be quiet

A young adult has just started an SSRI antidepressant for major depression. What should the nurse monitor most closely in the first weeks?

1. AHair growth and skin color
2. BRising blood glucose levels
3. CWeight loss from too much appetite
4. DThoughts of suicide or self-harm

A patient on a nasal cannula at 6 L/min still has a low SpO₂. What should the nurse do?

1. ARemove the oxygen to see if the SpO₂ changes
2. BRecheck the SpO₂ at the next routine set of observations in four hours
3. CTurn the nasal cannula up to 15 L/min
4. DReport it, because a different oxygen device is likely to be needed

A patient with Guillain-Barré syndrome has weakness that is spreading up from the legs. Which assessment has the highest priority?

1. AMuscle strength in the feet and ankles at the start of each morning
2. BBreathing strength, such as vital capacity and the ability to cough
3. CThe patient’s mood and coping
4. DSkin condition over the heels

A nurse has a needlestick injury from a used needle. What should the nurse do first?

1. ASqueeze the wound hard and suck it
2. BWash the area with soap and water
3. CScrub the area with bleach
4. DFinish the shift and report it tomorrow