Lembaran kerja Pemberian keutamaan & delegasi dengan jawapan

Which capillary refill time is prolonged in an adult?

1. A4 seconds
2. B1 second
3. CLess than 1 second
4. D2 seconds

A patient has a Glasgow Coma Scale score of 8. What is the main concern?

1. AThe patient only has a mild headache
2. BThe patient is fully alert and oriented
3. CThe patient may not be able to protect the airway
4. DThe patient can safely eat and drink without help

Which term means being answerable for your own actions and their results?

1. ADelegation
2. BAccountability
3. CAuthority
4. DAssignment

A patient has a tonic-clonic seizure in bed. What should the nurse do first?

1. AGive a drink of water to help the patient wake
2. BProtect the head and turn the patient on their side when possible
3. CPlace a tongue depressor between the teeth
4. DHold the arms and legs down firmly to stop the jerking movements quickly

A patient has heart failure. Which instruction about daily weights is best to give the nursing assistant?

1. A“Only weigh him if his ankles look more swollen than they did yesterday afternoon.”
2. B“Weigh him each morning before breakfast, on the same scale, and tell me the result.”
3. C“Weigh him after lunch, fully dressed, with his shoes on.”
4. D“Weigh him at any time today, on whichever scale is free.”

A nurse has given rapid-acting insulin, and then learns that the patient’s meal tray will be 45 minutes late. What should the nurse do?

1. AAsk the patient to walk around the ward until the food arrives
2. BGive a second, smaller dose of insulin when the meal tray finally arrives
3. CTell the patient to wait and do nothing until the tray comes
4. DGet the patient some carbohydrate food now and check the glucose

Discaj yang dirancang bagi pesakit manakah yang patut dipersoalkan oleh jururawat?

1. APesakit dua hari selepas pembedahan dengan kadar denyutan jantung baharu 112/min dan suhu 38.4 °C
2. BPesakit selepas pembaikan hernia yang sedang membuang air kecil dan makan
3. CPesakit dengan simen yang stabil yang berjalan dengan selamat menggunakan tongkat ketiak
4. DPesakit pneumonia yang tidak demam selama 48 jam dengan antibiotik oral

Seorang pesakit dengan kateter vena pusat tiba-tiba sesak nafas, dengan sakit dada dan SpO₂ yang menurun, semasa talian dikeluarkan. Apakah yang dilakukan oleh jururawat dahulu?

1. ATutup tapak itu, pusingkan ke sebelah kiri dengan kepala ke bawah, beri oksigen dan minta bantuan
2. BMinta pesakit menarik nafas dalam yang perlahan dan teruskan
3. CDudukkan pesakit tegak dan siapkan pengeluaran talian dengan cepat
4. DBilas kateter dengan salin untuk membersihkan sebarang sekatan