정답이 있는 우선순위 설정과 위임 학습지

To which patients do standard precautions apply?

1. AOnly patients with a confirmed infection on a lab test
2. BOnly patients in intensive care
3. CAll patients, whether or not an infection is known
4. DOnly patients with an open wound

Which patient needs a single room with airborne precautions?

1. AA patient with suspected pulmonary tuberculosis
2. BA patient with a urinary tract infection and a catheter
3. CA patient with a fractured femur
4. DA patient with type 2 diabetes

What does NPO mean on a patient’s care plan?

1. ANot for physical therapy
2. BNo pain observed
3. CNormal patient observations
4. DNothing by mouth

A patient’s chest tube becomes disconnected from the drainage system. What should the nurse do first?

1. APlace the end of the tube in a bottle of sterile water
2. BClamp the tube for the rest of the shift
3. CWait for the provider to arrive before doing anything else
4. DRemove the tube and cover the site

Which patient should the RN see first after receiving a report from the night nurse?

1. ADay 2 after bowel surgery, asking to start a soft diet
2. BDay 3 after bowel surgery, wants a shower and hair wash before breakfast
3. CDay 4 after bowel surgery, waiting for discharge teaching
4. DDay 1 after bowel surgery, new chest pain and heart rate 110/min

A patient taking clozapine reports a sore throat and fever. What is the priority action?

1. AAdvise the patient to gargle with warm salt water and rest in bed
2. BOffer throat lozenges and continue the usual dose
3. CHold the dose and report so the white cell count can be checked
4. DIncrease the dose because the symptoms suggest a relapse

A patient receiving comfort-focused end-of-life care is distressed by breathlessness. Which approach is most appropriate?

1. ALeave the patient alone so they can rest
2. BStart a series of aggressive tests to find the exact cause of the breathlessness
3. CWithhold all opioids because they may slow breathing
4. DGive prescribed opioids and use positioning and a fan to relieve breathlessness

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

1. AA muscle cramp that will pass with stretching
2. BChronic venous insufficiency that needs elevation
3. CA deep vein thrombosis that can be treated next week
4. DAcute arterial occlusion, which is an emergency