解答つき優先順位の決定と委任ワークシート

一般に、ほかの問題より先に対処されるのは、どの種類の問題ですか？

1. A以前の看護計画に挙げられた問題
2. B患者に現在ある顕在的な問題
3. C後で生じるかもしれない潜在的な（リスクの）問題
4. D退院に向けた学習ニーズ

Which task is appropriate to delegate to a nursing assistant for an immobile but stable patient?

1. APlanning the patient’s skin care
2. BTurning and repositioning the patient every 2 hours
3. CChoosing which wound dressing to use
4. DDeciding whether a pressure injury has got worse since yesterday

An adult arrives at the emergency department with chest pain. Which test should be done within about 10 minutes of arrival?

1. AAn exercise stress test
2. BA chest CT scan
3. CA 12-lead ECG
4. DA lipid profile

Which action by a nursing assistant needs the nurse to step in?

1. ALowering the bed to its lowest position and locking the wheels after care
2. BCleaning hands before entering the room
3. CTaking an oral temperature just after the patient drank cold water
4. DPutting the call light within the patient’s reach

After a hip replacement using a posterior approach, which statement shows a need for further teaching?

1. A“I will use a raised toilet seat at home.”
2. B“I will keep a pillow between my knees when I lie on my side in bed.”
3. C“I will cross my legs when I sit, so I am more comfortable.”
4. D“I will not bend my hip past 90 degrees.”

A swimmer is found unresponsive after diving into shallow water. Which method should the nurse use to open the airway?

1. ATurning the head to the side to drain water
2. BRaising the chin while bending the neck forward
3. CHead-tilt, chin-lift with full neck extension
4. DJaw thrust, keeping the head and neck in line

A provider asks a nurse to perform a procedure that is outside the nurse’s scope of practice. What should the nurse do?

1. AAsk a nursing assistant to do it instead
2. BDo it just this once and promise the provider not to do it again
3. CDecline, explain why and suggest who can safely do it
4. DDo it, because the provider gave the instruction

A medical-unit nurse is floated to intensive care and given a patient on a ventilator, which the nurse has never managed. What is the best response?

1. ARefuse to work and go home, because the assignment is unsafe
2. BAccept the full assignment without comment to avoid conflict
3. CTell the charge nurse about the gap, accept tasks within competence and ask for support
4. DLeave the intensive care unit and go back to the medical unit without telling anyone