解答つき基礎看護学ワークシート

成人で一般に発熱とみなされる体温はどれですか？

1. A37.0 °C 以上
2. B35.5 °C 以上
3. C36.5 °C 以上
4. D38.0 °C 以上

What is the pulse pressure?

1. AThe number of heartbeats felt at the wrist in one minute
2. BThe difference between the systolic and diastolic pressure
3. CThe pressure needed to stop the radial pulse
4. DThe average of the systolic and diastolic pressure

Which behaviour may show that a patient is in pain but cannot say so?

1. AGrimacing and guarding a part of the body
2. BReading a newspaper calmly
3. CSleeping quietly and breathing slowly
4. DEating a full meal and chatting

Where in the eye should eye drops be placed?

1. AInto the inner corner of the eye only
2. BOnto the upper eyelid while the eye is shut
3. CDirectly onto the centre of the cornea
4. DInto the pocket of the lower eyelid

A small blood spill is found on the ward floor. What is the correct approach?

1. ALeave it for the domestic staff to clean at the end of the day
2. BCover it with a sheet so no one steps in it
3. CWear gloves and an apron and clean it with an approved disinfectant per policy
4. DWipe it up with a paper towel without gloves, then wash your hands well afterwards

看護師が痛みに対して患者に鎮痛薬を投与しました。次の重要なステップは何ですか？

1. A投与量を記録し、患者が訴えなければ痛みはなくなったとみなす
2. Bすぐに 2 回目を投与する
3. C痛みについて尋ねるのは翌日まで待つ
4. D薬が効くまでの時間をおいて痛みを再評価する

While counting an apical pulse, the nurse finds the rhythm is irregularly irregular and the radial rate is lower than the apical rate. Which rhythm is most likely?

1. ASinus bradycardia
2. BAtrial fibrillation
3. CNormal sinus rhythm
4. DSinus tachycardia

A patient who had a GCS of 15 this morning now opens their eyes only to voice and is confused. What should the nurse do?

1. ARecord it and recheck at the next routine time
2. BTreat it as deterioration and escalate urgently
3. CLet the patient sleep, as they are probably tired
4. DGive a sedative to calm the confusion