Lembar kerja Prioritas & delegasi dengan jawaban

Bila hal lain sama, masalah mana yang biasanya diprioritaskan?

1. AMasalah yang paling dikhawatirkan keluarga
2. BMasalah akut yang baru
3. CMasalah kronis yang sudah lama, karena memengaruhi lebih banyak kehidupan pasien
4. DMasalah yang paling singkat waktu penyelesaiannya

Menurut hierarki kebutuhan Maslow, masalah pasien mana yang biasanya ditangani perawat lebih dulu?

1. ARisiko jatuh pada malam hari
2. BIsolasi sosial
3. CGangguan pertukaran gas
4. DHarga diri rendah

What is the purpose of the “time-out” just before a surgical procedure?

1. ATo count the swabs at the end of the operation
2. BTo give the surgeon a short rest before the operation starts
3. CTo let the family say goodbye to the patient
4. DTo confirm the correct patient, procedure and site

An anxious patient is breathing very fast and has tingling fingers. The blood gas shows pH 7,51 and PaCO₂ 29 mmHg (3,9 kPa). What should the nurse do first?

1. AGive IV sodium bicarbonate as soon as it can be found
2. BEncourage the patient to breathe even faster
3. CStay with the patient and coach slow, calm breathing
4. DGive oxygen at the highest flow and leave the room

A patient’s chest tube becomes disconnected from the drainage system. What should the nurse do first?

1. AClamp the tube for the rest of the shift
2. BPlace the end of the tube in a bottle of sterile water
3. CRemove the tube and cover the site
4. DWait for the provider to arrive before doing anything else

An older patient with dementia is restless at night and keeps trying to get out of bed. Which measure should the nurse try first?

1. AApply wrist restraints for the rest of the night
2. BGive a sedative from the as-needed list without first assessing the patient
3. CCheck for pain, thirst or a full bladder, and offer toileting
4. DRaise all four bed rails so the patient cannot climb out

Which patient finding after a total knee replacement needs the nurse’s action first?

1. APain of 4/10 when the physiotherapist bends the knee during the morning session
2. BSudden calf pain and swelling in the operated leg, with new breathlessness
3. CA small amount of dried blood on the dressing
4. DAsks for an ice pack to help with swelling around the knee

Pada triase START, seorang dewasa tidak bernapas. Jalan napas diposisikan ulang dan korban tetap tidak bernapas. Apa kategori yang benar?

1. AMerah, karena tidak bernapas adalah temuan yang paling mendesak
2. BMerah, dan segera mulai RJP
3. CHitam (meninggal atau ekspektan)
4. DKuning, dan kembali lagi nanti