Užduočių lapas tema Prioritetų nustatymas ir delegavimas su atsakymais

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Vardas: ____________________   Data: ____________

1.Lengvas

In the Emergency Severity Index (ESI), which patient fits level 2?

  1. AA stable patient who needs no resources
  2. BA stable patient who needs one resource
  3. CA patient who needs an immediate life-saving intervention to survive
  4. DA high-risk situation, new confusion, or severe pain or distress
2.Lengvas

Which hemoglobin result is low for an adult woman?

  1. A13,2 g/dL (132 g/L)
  2. B12,6 g/dL (126 g/L)
  3. C7,8 g/dL (78 g/L)
  4. D14,0 g/dL (140 g/L)
3.Lengvas

Which resting heart rate in an adult is bradycardia?

  1. A64/min
  2. B88/min
  3. C72/min
  4. D46/min
4.Vidutinis

A nurse teaches a patient about storing insulin at home. Which statement shows a need for further teaching?

  1. A“I will keep my spare insulin in the freezer so it lasts longer.”
  2. B“I will check the expiry date on the label before I use the vial.”
  3. C“I will keep unopened insulin in the fridge.”
  4. D“I will not leave my insulin in a hot car.”
5.Vidutinis

Which action by a nursing assistant needs the nurse to step in?

  1. ALowering the bed to its lowest position and locking the wheels after care
  2. BTaking an oral temperature just after the patient drank cold water
  3. CPutting the call light within the patient’s reach
  4. DCleaning hands before entering the room
6.Vidutinis

A patient had a colostomy formed yesterday. Which stoma appearance should be reported straight away?

  1. AMoist and pink-red
  2. BA little bleeding when cleaned
  3. CSlightly swollen
  4. DDark purple or black
7.Sunkus

After cardiac surgery, a patient becomes hypotensive with distended neck veins and muffled heart sounds, and chest drain output has suddenly stopped. What should the nurse suspect?

  1. AHypovolemic shock from dehydration
  2. BCardiac tamponade
  3. CA blocked urinary catheter
  4. DLeft-sided heart failure
8.Sunkus

A patient with COPD on 2 L/min oxygen becomes drowsy and hard to wake. The SpO₂ is 93%. What is the priority?

  1. AGive the as-needed sedative so the patient rests comfortably
  2. BAssess breathing and escalate for a blood gas, as carbon dioxide may be rising
  3. CLet the patient sleep, because the saturation is above target
  4. DIncrease the oxygen to 6 L/min so that the saturation goes even higher than now

Atsakymai

  1. 1. D · A high-risk situation, new confusion, or severe pain or distress
  2. 2. C · 7,8 g/dL (78 g/L)
  3. 3. D · 46/min
  4. 4. A · “I will keep my spare insulin in the freezer so it lasts longer.”
  5. 5. B · Taking an oral temperature just after the patient drank cold water
  6. 6. D · Dark purple or black
  7. 7. B · Cardiac tamponade
  8. 8. B · Assess breathing and escalate for a blood gas, as carbon dioxide may be rising

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