Užduočių lapas tema Prioritetų nustatymas ir delegavimas su atsakymais

Which term describes a patient who is unable to understand and decide about their own care?

1. AExercising autonomy
2. BFully competent
3. CLacking decision-making capacity
4. DProviding valid informed consent

A patient’s platelet count is 18,000/mm³ (18 × 10⁹/L). Which risk is the nursing priority?

1. AFluid overload
2. BBleeding
3. CBlood clots
4. DInfection

In delegation, what does supervision mean?

1. ASigning the delegate’s documentation without checking it
2. BGuidance, follow-up and evaluation of the delegated task by the nurse
3. CDoing every delegated task yourself to make sure that it is done right
4. DLeaving the delegate to finish without any contact

Kurią užduotį RN tinkamiausia deleguoti LPN/LVN?

1. ANaujo paciento priėmimo vertinimą
2. BPirmojo raudonųjų kraujo kūnelių vieneto pradėjimą perpilti
3. CIšrašymo mokymą pacientui, kuriam ką tik paskirtas insulinas
4. DNuolatinio šlapimo pūslės kateterio įvedimą stabiliam pacientui

A patient with a head injury is being monitored. Which set of findings suggests rising intracranial pressure?

1. ANormal blood pressure, normal pulse and clear speech
2. BFalling blood pressure, a fast pulse and warm, flushed dry skin
3. CLow temperature, fast breathing and a strong appetite
4. DRising systolic pressure, slow pulse and irregular breathing

During a blood transfusion, a patient develops chills, back pain and a fever. What is the nurse’s first action?

1. AStop the transfusion and keep the IV open with normal saline via new tubing
2. BFinish the unit quickly through a pressure bag so that the reaction does not last long
3. CGive an antipyretic and continue the transfusion
4. DSlow the transfusion and recheck in an hour

After a head injury, a patient passes large amounts of very dilute urine, is thirsty and has a rising serum sodium. Which condition is most likely?

1. AAcute kidney injury with oliguria
2. BDiabetic ketoacidosis
3. CSIADH
4. DDiabetes insipidus

After surgery, a patient who has taken long-term steroids becomes hypotensive and weak, and the blood pressure does not rise with IV fluids. Which problem should the nurse suspect?

1. AFluid overload from too much IV fluid
2. BAn allergic reaction to the anesthetic
3. CNormal tiredness after anesthesia
4. DAdrenal crisis from steroid withdrawal