Lembar kerja Prioritas & delegasi dengan jawaban

After caring for a patient with Clostridioides difficile diarrhea, how should the nurse clean their hands?

1. AWipe hands on a clean towel
2. BWash with soap and water
3. CUse alcohol hand rub only
4. DNo hand hygiene is needed if gloves were worn

When a nurse receives a critical lab result by phone, what does “read-back” mean?

1. ARepeating the result back to the caller to confirm it
2. BReading the result to the next shift at handover
3. CWaiting for the written report before doing anything
4. DReading the result aloud to the patient straight away

What does the Braden Scale measure?

1. AThe severity of alcohol withdrawal symptoms
2. BThe risk of falling during a hospital stay
3. CThe risk of developing a pressure injury
4. DThe level of consciousness after a head injury

The day after a total thyroidectomy, a patient reports tingling around the mouth and in the fingers. What should the nurse do first?

1. AGive the patient’s routine oral iron supplement early
2. BCheck for signs of low calcium and inform the provider
3. CEncourage deep breaths into a paper bag until it passes
4. DReassure the patient that this is normal after neck surgery

A patient taking lithium has vomiting, diarrhea and a new coarse tremor. What should the nurse do?

1. AGive the dose with food to reduce the stomach upset
2. BEncourage the patient to cut down on salt and fluids
3. CHold the next dose and report for an urgent lithium level
4. DReassure the patient that a coarse tremor is expected at first

Which patient is at the highest risk of falling?

1. AA 60-year-old admitted for chest pain that has since been ruled out by tests
2. BA 30-year-old after an appendectomy who walks with steady steps
3. CA 45-year-old with asthma who is alert and independent
4. DAn 84-year-old taking a diuretic who has fallen before and gets up at night

A patient taking an MAO inhibitor antidepressant is taught about diet. Which statement shows a need for further teaching?

1. A“A sudden severe headache is a warning sign.”
2. B“I will check with the pharmacist before cold remedies.”
3. C“I will avoid tap beer and red wine.”
4. D“I can still eat aged cheese and cured salami.”

A patient has a new spinal cord injury at C4. Which assessment is the priority?

1. ABreathing effort and ability to cough
2. BSkin over the sacrum and heels
3. CBowel sounds in all four abdominal quadrants
4. DAbility to feed themselves