Užduočių lapas tema Prioritetų nustatymas ir delegavimas su atsakymais

Which statement belongs in the Background part of an SBAR report?

1. A“I would like you to see him within the next 15 minutes.”
2. B“He was admitted three days ago with pneumonia and also has COPD.”
3. C“I think he may be developing sepsis.”
4. D“I am calling about Mr Khan because his blood pressure has dropped.”

Where is intramuscular epinephrine usually injected for anaphylaxis?

1. AThe buttock
2. BThe abdomen under the skin
3. CThe outer middle thigh
4. DA vein in the hand

Which serum sodium value is within the normal adult range?

1. A120 mEq/L (120 mmol/L)
2. B152 mEq/L (152 mmol/L)
3. C128 mEq/L (128 mmol/L)
4. D140 mEq/L (140 mmol/L)

A nurse has called the rapid response team for a deteriorating patient. What should the nurse do while waiting for the team?

1. AGo to the station to finish documentation for other patients
2. BGive a dose of every as-needed medication on the chart
3. CLeave the patient for a few minutes to find the relatives and explain what is happening
4. DStay with the patient, give oxygen as prescribed and have recent vital signs ready

One hour after a vaginal birth, the nurse finds a soft, boggy uterus and heavy bleeding. What is the first action?

1. AEncourage the patient to rest quietly
2. BMassage the fundus
3. COffer a meal and fluids
4. DApply an ice pack to the perineum

On a pediatric unit, which child does the nurse assess first?

1. AA child with croup who has a barking cough but no stridor at rest
2. BA child with asthma who is now quiet with very little air movement
3. CA child with a temperature of 38,2 °C after vaccination
4. DA child in a new arm cast with pink, warm fingers and pain of 5/10

Which finding most suggests a tension pneumothorax rather than a simple pneumothorax?

1. ASharp chest pain that is worse on deep breathing
2. BA small air leak seen on a routine chest X-ray
3. CMild breathlessness with reduced breath sounds on one side of the chest only
4. DTrachea shifted away from the affected side, with low blood pressure

Which nursing approach may raise intracranial pressure in a patient with a head injury?

1. ASpacing out care with rest periods in between activities
2. BDoing suctioning, turning and bathing all at the same time
3. CKeeping the room calm and quiet
4. DKeeping the head in line with the body