解答つき優先順位の決定と委任ワークシート

What does the Braden Scale measure?

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

Which task should the registered nurse not delegate to a nursing assistant?

1. AEvaluating whether the patient understood discharge teaching
2. BMaking an occupied bed
3. CWalking a stable patient up and down the corridor after lunch
4. DGiving a bed bath to a stable patient

委任において、「正しい監督と評価」とはどういう意味ですか？

1. A委任された人が、あとで自分の仕事を確認し、承認すること
2. B看護師が、委任したすべての業務を一瞬も目を離さず見守ること
3. C看護師が経過を追い、必要なら介入し、結果を確認すること
4. D師長が、勤務終了時に委任されたすべての業務を承認すること

A parent of a child with influenza talks with the nurse. Which statement shows a need for further teaching?

1. A“I will call if my child has trouble breathing.”
2. B“I will keep my child home from school and away from others while unwell.”
3. C“I will give my child plenty of fluids.”
4. D“I will give my child aspirin to bring the fever down.”

ESI を用いたとき、最も高い緊急度レベルになるのはどの患者ですか？

1. A足首の骨折の疑いがある患者
2. B反応がなく、あえぐような不規則な呼吸をしている患者
3. C3 日間のどが痛く、バイタルサインが正常な患者
4. D胸痛があり、バイタルサインが正常な患者

A nursing assistant tells the RN that a patient’s IV pump is alarming. What is the best response?

1. A“I will come and check the pump and the IV site now.”
2. B“Turn the pump off and on again until it stops.”
3. C“Silence the alarm and I will check it at the end of the shift.”
4. D“Increase the rate a little so the alarm clears.”

An older patient has bruises of different ages and seems frightened when a relative visits. What is the nurse’s priority?

1. AAsk the relative directly in front of the patient whether they hit her
2. BIgnore it, because older people bruise easily
3. CTell the patient she must leave home and go to live somewhere else
4. DEnsure the patient’s safety, document the findings and report as required

An infant with pyloric stenosis has repeated projectile vomiting. Which acid-base imbalance is most likely?

1. AMetabolic alkalosis
2. BRespiratory acidosis
3. CRespiratory alkalosis
4. DMetabolic acidosis