Lembar kerja Prioritas & delegasi dengan jawaban

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

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

In the United States, which law sets out the scope of nursing practice in each state?

1. AThe state Nurse Practice Act
2. BThe Food and Drug Administration rules
3. CThe hospital’s visitor policy
4. DThe federal tax code

Which resting heart rate in an adult is bradycardia?

1. A46/min
2. B88/min
3. C64/min
4. D72/min

Which practice makes a shift handover safest?

1. AA structured format, such as SBAR, with time for questions
2. BLeaving a sticky note on the computer screen for the next nurse
3. CHanding over only the patients who had problems during the shift
4. DA quick chat in the corridor with no notes taken

A nurse has called the rapid response team for a deteriorating patient. What should the nurse do while waiting for the team?

1. AGive a dose of every as-needed medication on the chart
2. BLeave the patient for a few minutes to find the relatives and explain what is happening
3. CStay with the patient, give oxygen as prescribed and have recent vital signs ready
4. DGo to the station to finish documentation for other patients

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

A charge nurse notices that a nurse smells of alcohol and is slurring words at the start of the shift. What is the priority?

1. ARemove the nurse from patient care and report it according to policy
2. BLet the nurse work, but only with stable patients
3. CWait until the end of the shift and then discuss the concern with the nurse privately
4. DAsk the nurse to drink coffee and then start work

A patient has a chest drain for a pneumothorax. The nurse sees constant bubbling in the water-seal chamber. What does this most likely mean?

1. AThe lung has fully re-expanded, so the drain is ready to come out
2. BThe suction is set too low and needs to be turned up
3. CThe drain is working normally and no action is needed
4. DAn air leak in the patient or the system that needs checking