Prioritization / Delegation QuestionDifficulty
A 49 year-old male is having chest pain. You have a nursing assistant available. Which of the following interventions can be appropriately delegated to this assistant? Select all that apply....
You are caring for a 90 year old female who has a UTI. It is important to monitor for sepsis. Which abnormal vital sign would cause concern for sepsis? Select all that apply....
A 90 year-old female is brought to the ER from her nursing home. The staff report that the patient is acting weird and has had a fever for a few days. You assess the patient’s temperature and it is 103 F orally. Which labs are important to collect for this patient? Select all that apply....
A 25 year-old female with altered mental status and fruity breath has been brought into the ER. You know this patient is likely in Diabetic Ketoacidosis (DKA), which interventions are the most important? Select all that apply...
A 33 year-old male with abdominal pain has come into the ED. The patient needs vital signs, a urine sample, triage, an assessment and pain medications. Which interventions can the nurse delegate? Select all that apply...
A 50 year-old male with a history of endocarditis reports he is having a hard time breathing and it feels like an elephant is sitting on his chest. Which interventions are a priority? Select all that apply....
You have a 2-day-old with only one wet diapers since birth, which is concerning for dehydration. What other assessments could indicate dehydration? Select all that apply....
A one week old male has been admitted for sepsis. The nurse knows that which of the following things are the most important to monitor closely? Select all that apply....
You are working in the emergency department as the triage nurse tonight. Which of the following patients would be classified as medium/yellow/priority 2? Select all that apply....
Your patient has been diagnosed with a hemothorax. What is your priority nursing intervention at this time?...
You are admitting a patient with pneumonia. Which of the following orders should be implemented first?...
Which of the following nursing interventions prevents tracheal necrosis in an intubated patient?...
Your patient has been ventilated for 2 weeks. Her FiO2 has been at 60% for the last 48 hours. What are you MOST concerned about with an FiO2 at 60% for an extended period of time?...
You have just recieved an order to extubate your patient on mechanical ventilation. Which of the following nursing interventions should you complete just before extubation?...
Your patient is intubated. Which of the following nursing interventions it the priority for this patient?...
Your patient has just been extubated. Which of the following breath sounds is the MOST concerning at this time?...
Which of the following patients must be seen immediately?...
Your patient had a tracheostomy placed a few days ago. You walk into their room to complete your assessment. Which of the following observations would be the MOST concerning to you?...
You are admitted a patient to your med-surg unit from the ICU who had a tracheostomy placed 72 hours ago. Which of the following pieces of equipment is the priority to keep at the bedsite at all times?...
Your patient has had a tracheostomy placed. Which of the follow precautions is the priority at this time?...