Užduočių lapas tema Prioritetų nustatymas ir delegavimas su atsakymais

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

1. AGoggles
2. BGown
3. CMask
4. DGloves

After chemotherapy, a patient has a very low neutrophil count. Which risk is the nursing priority?

1. ADehydration
2. BBleeding
3. CInfection
4. DHypertension

Which value is the usual target INR for a patient taking warfarin for atrial fibrillation?

1. A6,0–7,0
2. B2,0–3,0
3. C0,5–1,0
4. D4,0–5,0

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

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

A patient’s chest tube becomes disconnected from the drainage system. What should the nurse do first?

1. ARemove the tube and cover the site
2. BWait for the provider to arrive before doing anything else
3. CPlace the end of the tube in a bottle of sterile water
4. DClamp the tube for the rest of the shift

An older patient with dementia is restless at night and keeps trying to get out of bed. Which measure should the nurse try first?

1. AGive a sedative from the as-needed list without first assessing the patient
2. BRaise all four bed rails so the patient cannot climb out
3. CApply wrist restraints for the rest of the night
4. DCheck for pain, thirst or a full bladder, and offer toileting

A patient taking an MAO inhibitor antidepressant is taught about diet. Which statement shows a need for further teaching?

1. A“I can still eat aged cheese and cured salami.”
2. B“I will check with the pharmacist before cold remedies.”
3. C“I will avoid tap beer and red wine.”
4. D“A sudden severe headache is a warning sign.”

An 85-year-old resident becomes newly confused and is falling, but has no fever. Which cause should the nurse consider first?

1. ANormal aging that needs no assessment
2. BAn infection, such as a urinary tract infection, presenting atypically
3. CA sudden worsening of long-standing dementia that needs no tests
4. DBoredom from not having enough activities