解答つき優先順位の決定と委任ワークシート

無料で印刷できる優先順位の決定と委任のワークシート：やさしい問題から試験レベルまで 8 問、解答つき。印刷するか PDF で保存できます。

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名前: ____________________   日付: ____________

1.やさしい

Which value is the usual target INR for a patient taking warfarin for atrial fibrillation?

  1. A0.5–1.0
  2. B2.0–3.0
  3. C6.0–7.0
  4. D4.0–5.0
2.やさしい

ABC の枠組みで、循環の問題はどれですか？

  1. A止まらない出血
  2. B呼吸数 32 回/分
  3. C不安
  4. D喘鳴（ストライダー）
3.やさしい

3 段階のトリアージ分類で、「緊急」にあたる患者はどれですか？

  1. A発熱のない、3 日間の発疹
  2. Bバイタルサインが正常な、2 日間の腹痛
  3. C発汗と息切れを伴う胸痛
  4. D処方の再発行の依頼
4.ふつう

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. BRemove the tube and cover the site
  3. CWait for the provider to arrive before doing anything else
  4. DPlace the end of the tube in a bottle of sterile water
5.ふつう

On day 3 after hip surgery, a patient suddenly becomes short of breath with sharp chest pain and an SpO₂ of 88%. What should the nurse do first?

  1. AEncourage the patient to walk to improve the circulation
  2. BGive the next dose of oral analgesia and reassess the patient in an hour
  3. CMassage the patient’s calves to ease any muscle cramp
  4. DRaise the head of the bed, give oxygen and call for urgent help
6.ふつう

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

A patient suddenly has severe pain in one leg. The leg is pale and cold with no pedal pulse. What does this suggest?

  1. AChronic venous insufficiency that needs elevation
  2. BA muscle cramp that will pass with stretching
  3. CA deep vein thrombosis that can be treated next week
  4. DAcute arterial occlusion, which is an emergency
8.むずかしい

A patient is deteriorating quickly. The nurse has called the provider twice, but the provider has not come. What is the best action?

  1. AWait another hour and call the provider again
  2. BDocument the concern and continue routine care
  3. CActivate the rapid response team
  4. DAsk the patient’s family to call the provider

解答

  1. 1. B · 2.0–3.0
  2. 2. A · 止まらない出血
  3. 3. C · 発汗と息切れを伴う胸痛
  4. 4. D · Place the end of the tube in a bottle of sterile water
  5. 5. D · Raise the head of the bed, give oxygen and call for urgent help
  6. 6. C · Assess the lungs, oxygen saturation and swelling, then inform the provider
  7. 7. D · Acute arterial occlusion, which is an emergency
  8. 8. C · Activate the rapid response team

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