Lembaran kerja Pemberian keutamaan & delegasi dengan jawapan

In a three-level triage system, what does “urgent” mean?

1. AMinor, and can safely wait for several hours
2. BAlready deceased on arrival
3. CSerious but stable for now, and needs care soon
4. DLife-threatening and needs care immediately

Which finding in an infant is a sign of breathing difficulty?

1. APink, warm hands and feet
2. BA strong cry
3. CWet diapers every few hours
4. DNasal flaring

How many levels does the Emergency Severity Index have?

1. AFive
2. BSix
3. CFour
4. DThree

A patient with type 1 diabetes has vomited since morning and cannot eat. Which action is most important?

1. AEncourage a large meal to settle the stomach
2. BCheck the blood glucose and ketones and contact the provider
3. CWait until tomorrow to see if the vomiting settles
4. DStop all insulin until the patient is able to eat normally again

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

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

A patient has a reddened area on the sacrum that does not blanch when pressed. What is the priority action?

1. AKeep the patient lying on the back to protect the area
2. BRelieve pressure on the area by changing position regularly
3. CApply a heat pad to the area to increase circulation
4. DMassage the area firmly to improve the blood flow to the skin

A patient at 34 weeks of pregnancy has painless, bright red vaginal bleeding. Which action should the nurse avoid?

1. AMeasuring the blood pressure and pulse
2. BMonitoring the fetal heart rate
3. CWeighing the pads to estimate blood loss
4. DA vaginal examination

Tugas manakah yang paling sesuai dilakukan sendiri oleh RN dan bukan didelegasikan kepada pembantu jururawat?

1. AMengeluarkan pesakit dari katil buat kali pertama selepas pembedahan
2. BMenimbang pesakit kegagalan jantung setiap pagi
3. CMembawa pesakit yang stabil berjalan di koridor pada hari ketiga selepas pembedahan
4. DMembantu pesakit dengan penjagaan mulut