优先排序与委派练习卷（附答案）

在确定护理优先次序的 ABC 框架中，首先处理哪项需要？

1. A气道
2. B循环
3. C疼痛
4. D呼吸

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

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

Which statement belongs in the Background part of an SBAR report?

1. A“I would like you to see him within the next 15 minutes.”
2. B“He was admitted three days ago with pneumonia and also has COPD.”
3. C“I am calling about Mr Khan because his blood pressure has dropped.”
4. D“I think he may be developing sepsis.”

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

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

A nurse teaches a patient about levothyroxine. Which statement shows a need for further teaching?

1. A“I will keep taking it even when I feel well.”
2. B“I will take it on an empty stomach with a glass of water.”
3. C“I will take it at breakfast with my calcium tablet.”
4. D“I will take it at the same time each morning.”

On day 3 after hip surgery, a patient suddenly becomes short of breath with sharp chest pain and an SpO₂ of 88%. What should the nurse do first?

1. AEncourage the patient to walk to improve the circulation
2. BGive the next dose of oral analgesia and reassess the patient in an hour
3. CMassage the patient’s calves to ease any muscle cramp
4. DRaise the head of the bed, give oxygen and call for urgent help

A patient with raised intracranial pressure is being nursed on the ward. Which position is best?

1. AFlat on the back with the head turned well over to one side
2. BHead of the bed at about 30 degrees with the neck straight
3. CSitting forward with the chin on the chest
4. DHead down with the legs raised above the heart

一名上消化道出血的患者心率 128 次/分，血压 84/50 mmHg。以下都有医嘱。护士首先开始哪一项？

1. A口服铁片
2. B预约次日早晨的诊断性内镜检查
3. C静脉输注质子泵抑制剂
4. D通过大口径套管静脉输液或输血