Приоритизация и делегирование: лист заданий с ответами

What is the normal baseline fetal heart rate?

1. A110–160/min
2. B40–60/min
3. C60–100/min
4. D160–220/min

Which white blood cell count suggests an infection or inflammation?

1. A18,000/mm³ (18 × 10⁹/L)
2. B8,200/mm³ (8,2 × 10⁹/L)
3. C7,000/mm³ (7 × 10⁹/L)
4. D6,500/mm³ (6,5 × 10⁹/L)

Which symptoms are classic signs of digoxin toxicity?

1. AHair loss and weight gain
2. BNausea, poor appetite and yellow-green visual halos
3. CHigh blood sugar and increased thirst
4. DA rash, high fever and swollen lymph nodes in the neck

A patient on hemodialysis has an arteriovenous fistula in the left arm. Which instruction should the nurse give the nursing assistant?

1. AHelp the patient carry shopping bags on the left arm
2. BMeasure blood pressure on the left arm only, every 4 hours
3. CDo not measure blood pressure on the left arm
4. DKeep the left arm wrapped tightly in a bandage at night

Two nursing assistants argue loudly at the station about their assignments. What is the charge nurse’s best first step?

1. AMeet both of them privately to hear each side
2. BChange both of their assignments without any discussion
3. CReport them to human resources at once
4. DIgnore it and hope they sort it out

A patient’s peripheral IV site is swollen, pale and cool, and the infusion has slowed. What should the nurse do first?

1. AFlush the cannula hard to clear the blockage
2. BApply a tight bandage over the site to reduce swelling
3. CIncrease the infusion rate to overcome the resistance
4. DStop the infusion and remove the cannula

A patient with severe sepsis starts oozing blood from IV sites and the gums, and bruises appear on the skin. What should the nurse suspect?

1. ADisseminated intravascular coagulation (DIC)
2. BNormal bruising from blood tests
3. CVitamin C deficiency
4. DAn allergic reaction to the adhesive tape

A patient in hypovolemic shock is receiving IV fluids. Which finding best shows that the treatment is working?

1. AUrine output at least 0,5 mL/kg/h and clearer thinking
2. BNew crackles at both lung bases
3. CA heart rate that keeps rising after each bag of fluid
4. DCooler, paler skin on the arms and legs