Užduočių lapas tema Prioritetų nustatymas ir delegavimas su atsakymais

When taking off protective equipment, which item is usually removed first?

1. AGown
2. BMask
3. CGloves
4. DGoggles

What is the range of possible scores on the Glasgow Coma Scale?

1. A0 to 15
2. B0 to 10
3. C1 to 20
4. D3 to 15

What is the CIWA scale used to assess?

1. AThe risk of a pressure injury
2. BThe severity of alcohol withdrawal
3. CThe depth of a burn wound
4. DThe severity of a newborn’s jaundice

A patient is in skeletal traction. Which finding needs the nurse to act?

1. AThe patient’s body is in line with the traction
2. BThe ropes are in the pulleys
3. CThe weights are resting on the floor
4. DThe weights are hanging freely

Using the Emergency Severity Index, which level fits a 70-year-old with chest pressure that suggests a heart attack, but normal vital signs?

1. ALevel 2
2. BLevel 5
3. CLevel 1
4. DLevel 4

A nurse teaches a patient who uses home oxygen. Which statement shows a need for further teaching?

1. A“I will keep the oxygen away from the gas stove.”
2. B“I will put up no-smoking signs at the front door and in my room.”
3. C“I will not use oil-based creams on my face.”
4. D“My husband can smoke in my room if the window is open.”

The charge nurse overhears four instructions from an RN to a nursing assistant. Which one needs to be corrected?

1. A“Check his glucose and give the insulin according to the sliding scale.”
2. B“Walk him to the bathroom and back, and stay with him the whole time.”
3. C“Help him wash and change, and tell me at once if you see any red or broken skin.”
4. D“Check his glucose before lunch and tell me the number straight away.”

A nurse sees a colleague put a vial of an opioid into their own pocket instead of returning it. What should the nurse do?

1. ATell the patients to watch the colleague carefully
2. BReport it to the nurse manager according to policy
3. CSay nothing, because it is not their business
4. DAsk the colleague to share the vial with them