解答つき優先順位の決定と委任ワークシート

Using the RACE fire response, what does the nurse do first when finding a fire in a patient’s room?

1. ARescue patients in immediate danger
2. BClose doors to contain the fire and smoke
3. CPull the fire alarm
4. DUse an extinguisher on the fire

Which of these is one of the standard “rights” of medication administration?

1. ARight patient
2. BRight ward
3. CRight brand
4. DRight colleague

ほとんどの現場で、救急部の新規来院者のトリアージを行うのは誰ですか？

1. A病棟事務員
2. BRN の関与がない LPN/LVN
3. C看護師（RN）
4. D看護助手

A patient is raising his voice, pacing and clenching his fists. What should the nurse do first?

1. AApply physical restraints at once
2. BSpeak calmly, keep a safe distance and invite him to talk about what is wrong
3. CTurn away and ignore the behavior
4. DStand very close to him and tell him firmly and loudly to sit down and be quiet

A patient receiving IV magnesium sulfate for pre-eclampsia has absent knee reflexes and a respiratory rate of 10/min. What does the nurse do first?

1. AGive oral fluids to help clear the drug faster
2. BIncrease the infusion to prevent a seizure
3. CTurn the patient onto her back and recheck later
4. DStop the magnesium infusion and call for help

A patient’s peripheral IV site is swollen, pale and cool, and the infusion has slowed. What should the nurse do first?

1. AIncrease the infusion rate to overcome the resistance
2. BFlush the cannula hard to clear the blockage
3. CStop the infusion and remove the cannula
4. DApply a tight bandage over the site to reduce swelling

看護師は、処方された用量が安全でないと考えています。処方者は、それでも投与するよう言います。看護師はどうすべきですか？

1. A投与を保留し、指揮系統を通じてエスカレーションする
2. B妥協案として半量を投与し、理由を記録する
3. C対立を避けるために、黙って投与を飛ばし、何も言わない
4. D処方者に責任があるので、投与する

Which nursing approach may raise intracranial pressure in a patient with a head injury?

1. ADoing suctioning, turning and bathing all at the same time
2. BKeeping the room calm and quiet
3. CKeeping the head in line with the body
4. DSpacing out care with rest periods in between activities