优先排序与委派练习卷（附答案）

In stroke care, what does the “last known well” time mean?

1. AThe time the first symptom was noticed by a stranger
2. BThe time the patient arrived at the hospital and was triaged
3. CThe time of the patient’s last meal
4. DThe last time the patient was seen without stroke symptoms

In the ABC framework, which finding is mainly a breathing problem?

1. AStridor caused by a swollen throat
2. BHeart rate 150/min with a low blood pressure and cold skin
3. CShallow breaths with an SpO₂ of 85% on room air
4. DA blood glucose of 60 mg/dL (3.3 mmol/L)

Which drug is used to reverse the effect of warfarin?

1. AFlumazenil
2. BNaloxone
3. CVitamin K
4. DProtamine sulfate

A patient had a colostomy formed yesterday. Which stoma appearance should be reported straight away?

1. AMoist and pink-red
2. BDark purple or black
3. CSlightly swollen
4. DA little bleeding when cleaned

A patient with mild dysphagia after a stroke is eating. Which technique helps make swallowing safer?

1. ATalking while eating to stay alert
2. BDrinking thin fluids quickly through a straw between bites
3. CSitting upright with the chin tucked down while swallowing
4. DLying flat with the head tilted back

一名护理助理报告说某患者的血压是 168/98 mmHg（早些时候是 130/80），且患者头痛。RN 应怎么做？

1. A让助理一小时后复测血压
2. B记录该数值，继续发药
3. C让助理现在就给予按需使用的降压药
4. D评估患者，复测血压，并寻找症状

A trauma patient has an open leg fracture, absent breath sounds on one side, a trachea shifted to the other side and a falling blood pressure. Which problem is the priority?

1. AThe pain from the fracture
2. BThe open fracture of the leg
3. CThe risk of wound infection
4. DThe suspected tension pneumothorax

Which patient with cirrhosis should the nurse see first?

1. ALarge ascites that is unchanged from yesterday
2. BVomiting bright red blood, heart rate 120/min
3. CWants to talk about stopping drinking alcohol for good
4. DLong-standing jaundice and itchy skin, asking for cream