Užduočių lapas tema Prioritetų nustatymas ir delegavimas su atsakymais

Kas yra triažas?

1. APacientų paskirstymas po lygiai budintiems slaugytojams
2. BPacientų rūšiavimas pagal tai, kaip skubiai jiems reikia pagalbos
3. CPacientų perkėlimas tarp skyrių pagal laisvas lovas
4. DPacientų gydymas griežtai atvykimo eile

A nurse is worried about a patient’s worsening condition, and the provider does not respond to the concern. Following the chain of command, whom does the nurse usually contact next?

1. AThe hospital’s chief executive
2. BThe pharmacy technician on duty that day
3. CThe charge nurse or nursing supervisor
4. DThe patient’s next of kin

What is status epilepticus?

1. AA faint caused by standing up too quickly
2. BA seizure that happens only during sleep
3. CA seizure lasting 5 minutes or more, or repeated seizures without recovery
4. DA single short seizure that stops on its own within a minute or two

A patient taking warfarin has an INR of 5,2 and no signs of bleeding. What should the nurse do?

1. AGive a double dose to correct the result
2. BEncourage the patient to take aspirin for pain
3. CHold the warfarin dose and inform the provider
4. DGive the usual dose and recheck the INR next month

A patient with a spinal cord injury at T4 suddenly has a severe headache, flushing above the injury and a blood pressure of 200/110 mmHg. What does the nurse do first?

1. ASit the patient upright with the legs lowered
2. BLay the patient flat with the legs raised
3. CGive a warm drink and recheck the blood pressure in an hour
4. DApply extra blankets to keep the patient warm and calm

Atliekant START triažą, nevaikštantis suaugusysis kvėpuoja 22 kartus per minutę, turi stipininės arterijos pulsą ir vykdo paprastus nurodymus, bet turi akivaizdų kojos lūžį. Kokia kategorija jam suteikiama?

1. AGeltona (atidėtina)
2. BŽalia (lengva)
3. CRaudona (neatidėliotina)
4. DJuoda (tikėtina mirtis)

After handover on a medical unit, which patient should the nurse see first?

1. ADay 2 after a hernia repair, pain 6/10, oral analgesic due in 20 minutes, wants it now
2. BPneumonia on 2 L/min oxygen, SpO₂ 93%, talking in full sentences
3. CNew atrial fibrillation, heart rate 150/min, blood pressure 86/50 mmHg, dizzy
4. DDeep vein thrombosis on a heparin infusion, aPTT in the target range

Stebimas pacientas su galvos trauma ir kojos lūžiu. Kuris radinys yra prioritetas?

1. AGlazgo komos skalės balas krenta nuo 15 iki 12
2. BPacientas prašo ko nors paskanauti
3. C6/10 kojos skausmas, nepaisant paskutinės nuskausminamojo dozės
4. DNedidelis nubrozdinimas ant alkūnės