Užduočių lapas tema Prioritetų nustatymas ir delegavimas su atsakymais

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

1. A2,0–3,0
2. B4,0–5,0
3. C0,5–1,0
4. D6,0–7,0

Which capillary refill time is prolonged in an adult?

1. ALess than 1 second
2. B2 seconds
3. C4 seconds
4. D1 second

After chemotherapy, a patient has a very low neutrophil count. Which risk is the nursing priority?

1. ADehydration
2. BInfection
3. CBleeding
4. DHypertension

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

1. AOffer throat lozenges and continue the usual dose
2. BAdvise the patient to gargle with warm salt water and rest in bed
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 parent calls to say their toddler has just swallowed drain cleaner. What should the nurse advise?

1. ADo not make the child vomit; call poison control or emergency services now
2. BWait to see whether the child develops any symptoms first
3. CMake the child vomit straight away to bring up the chemical
4. DGive a large glass of fizzy drink or milk to dilute the cleaner before calling anyone

Kuris nurodymas slaugytojo padėjėjui yra aiškiausias?

1. A„Išmatuok ponui Li kraujospūdį 10:00 ir nedelsdamas pasakyk man, jei sistolinis žemesnis nei 100."
2. B„Atlik pono Li gyvybinių rodiklių matavimą kada nors iki pietų ir surašyk man į lentelę."
3. C„Pasakyk man, jei pas poną Li kas nors atrodys negerai."
4. D„Šį rytą pažiūrėk į poną Li ir pasakyk, kaip jam sekasi."

Two days after starting haloperidol, a patient suddenly develops painful neck twisting and the eyes roll upwards. What should the nurse anticipate?

1. APhysical restraint until the spasm passes
2. BAn anticholinergic drug, such as benztropine or procyclidine, as prescribed
3. CNo action, because the spasm is a sign of improvement
4. DA higher dose of haloperidol to calm the patient and stop the movements quickly

Before surgery, a nurse is asked to witness a patient’s consent. The patient was given a sedative 30 minutes ago. What should the nurse do?

1. AAsk a family member to sign on the patient’s behalf
2. BWitness it quickly before the sedative takes full effect
3. CNot witness the consent and inform the surgeon
4. DWitness it and write “sedated” beside the signature