उत्तरों सहित मेड-सर्ज: पाचन, शल्य-पूर्व/पश्चात और कैंसर वर्कशीट

Which factor most increases the risk of Clostridioides difficile infection?

1. ADrinking bottled water
2. BRecent antibiotic treatment
3. CRegular exercise
4. DA diet high in fibre

Which bedside test is commonly used to check that a nasogastric tube is in the stomach before each use?

1. AListening for a "whoosh" of injected air
2. BAsking the patient whether it feels comfortable
3. CPutting the tube end in a cup of water
4. DTesting aspirate with pH paper

Which signs suggest peritonitis?

1. AA small, painless lump near the umbilicus
2. BLoud bowel sounds with a hungry feeling
3. CGuarding, rebound tenderness and a rigid abdomen
4. DA soft abdomen with no pain on pressing

Which initial treatment is usual for symptomatic hypercalcaemia of malignancy?

1. AA high-calcium diet with extra milk
2. BIV fluids followed by an IV bisphosphonate
3. COral calcium tablets and vitamin D
4. DFluid restriction and a thiazide diuretic

Which description fits a category (stage) 4 pressure ulcer?

1. AA blister filled with clear fluid over the heel or sacrum
2. BA shallow wound into the dermis only
3. CFull-thickness loss with exposed bone, tendon or muscle
4. DIntact skin with redness that does not blanch

Why are antimotility drugs such as loperamide avoided in C. difficile infection?

1. AThey kill the normal bowel bacteria
2. BThey make the stool sample test positive falsely
3. CThey cause serious liver failure in most patients who take them
4. DThey may keep toxin in the bowel and risk toxic megacolon

A patient who takes NSAIDs suddenly develops severe epigastric pain, a rigid abdomen and shoulder-tip pain. Which finding would most support the likely diagnosis?

1. AA raised serum lipase three times the upper limit
2. BTall, peaked T waves on a 12-lead ECG
3. CFree air under the diaphragm on an erect chest X-ray
4. DFluid levels in the bladder on an ultrasound scan

A nurse teaches a patient to self-inject low molecular weight heparin at home. Which statement shows a need for further teaching?

1. A"I'll change the injection site each day."
2. B"I'll put the used syringe in the sharps bin."
3. C"I'll report any unusual bruising or bleeding."
4. D"I'll rub the area afterwards to spread the medicine."