Užduočių lapas tema Prioritetų nustatymas ir delegavimas su atsakymais

Slaugytojo padėjėjas praneša apie keturis radinius. Kurį slaugytojas turėtų patikrinti pirmiausia?

1. APacientą, kurio pusryčių padėklas nesuvalgytas
2. BPacientą, kuris prašo dar vieno pledo
3. CPacientą, kuris staiga negali pajudinti dešinės rankos
4. DPacientą, kuris nori paskambinti artimajam

Which finding meets the usual definition of orthostatic hypotension?

1. ASystolic pressure rises by 20 mmHg or more within 3 minutes of standing up
2. BBlood pressure is the same lying and standing
3. CHeart rate falls by 5/min after lying down
4. DSystolic pressure falls by 20 mmHg or more within 3 minutes of standing

When is the Apgar score usually assessed?

1. AAt the first postnatal clinic visit
2. BAt 1 and 5 minutes after birth
3. CBefore the baby is born
4. DOnly at 24 hours after birth

During labor, the nurse sees the umbilical cord in the vagina after the membranes rupture. What is the first action?

1. AWait for the next contraction before acting
2. BPush the cord back into the uterus
3. CAsk the patient to walk around the room to bring the baby lower and speed up labor
4. DRelieve pressure on the cord by lifting the presenting part with a gloved hand

A patient with asthma uses a peak flow meter. A reading below 50% of personal best is in the red zone. Which statement shows correct understanding?

1. A“I will go for a short run to open up my lungs.”
2. B“I will stop all my inhalers until the reading is back up.”
3. C“I will use my reliever inhaler and get emergency help straight away.”
4. D“I will wait until tomorrow morning to see if the reading gets better on its own.”

A nurse takes a telephone order from a provider. What must the nurse do?

1. ARemember the order and write it in the chart at the end of the shift
2. BWrite the order down and read it back to the provider to confirm it
3. CCarry out the order first and ask the provider to confirm it later
4. DAsk the ward clerk to take the order on the nurse’s behalf instead

A patient in acute mania paces constantly, has lost weight and will not sit down to eat. Which intervention is most helpful?

1. ALeave meals in the room and let the patient eat whenever and whatever they choose
2. BOffer high-calorie finger foods and drinks the patient can take while moving
3. CWait until the mania settles before worrying about nutrition
4. DInsist that the patient sits at the table until the meal is finished

A patient was knocked out briefly in a fall, then woke and talked normally. Two hours later the patient becomes drowsy and one pupil is larger. What is the most likely cause?

1. AAn epidural hematoma
2. BLow blood sugar from missing a meal
3. CA mild concussion that is settling
4. DNormal tiredness after a fall