Ustalanie priorytetów i delegowanie: karta pracy z odpowiedziami

Which task should the registered nurse not delegate to a nursing assistant?

1. AGiving a bed bath to a stable patient
2. BEvaluating whether the patient understood discharge teaching
3. CWalking a stable patient up and down the corridor after lunch
4. DMaking an occupied bed

W triażu masowych zdarzeń, co zwykle oznacza czerwona karta?

1. AOdroczona: poważne obrażenia, ale stan chwilowo stabilny
2. BDrobne obrażenia: osoba może chodzić i bezpiecznie poczekać
3. COczekujący (expectant): mało prawdopodobne przeżycie nawet przy opiece lub osoba już nie żyje
4. DNatychmiastowa pomoc: stan zagrażający życiu, ale możliwy do przeżycia przy szybkiej opiece

A patient’s urine output is 15 mL/h for three hours. How should the nurse classify this in an adult?

1. AHigh, suggesting fluid overload
2. BNormal for an adult at rest
3. CLow and needing to be reported
4. DExpected after drinking fluids

A patient is receiving continuous tube feeds. Which action best reduces the risk of aspiration?

1. ALay the patient flat for an hour after each bag is hung
2. BKeep the head of the bed raised to at least 30 degrees
3. CIncrease the feed rate so the stomach empties sooner
4. DTurn the feed off only while the patient is asleep at night

Asystent pielęgniarski zgłasza, że ciśnienie tętnicze pacjenta wynosi 168/98 mmHg (wcześniej 130/80), a pacjent ma ból głowy. Co powinna zrobić RN?

1. APoprosić asystenta o ponowny pomiar ciśnienia za godzinę
2. BPoprosić asystenta o podanie teraz doraźnego leku hipotensyjnego
3. COcenić pacjenta, ponownie zmierzyć ciśnienie tętnicze i poszukać objawów
4. DUdokumentować wartość i kontynuować rozdawanie leków

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. BLeave the patient for a few minutes to find the relatives and explain what is happening
3. CGive a dose of every as-needed medication on the chart
4. DStay with the patient, give oxygen as prescribed and have recent vital signs ready

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 avoid tap beer and red wine.”
3. C“I will check with the pharmacist before cold remedies.”
4. D“A sudden severe headache is a warning sign.”

An infant with pyloric stenosis has repeated projectile vomiting. Which acid-base imbalance is most likely?

1. ARespiratory acidosis
2. BRespiratory alkalosis
3. CMetabolic acidosis
4. DMetabolic alkalosis