公式集、全トピックの解法の要点、6 問の演習問題。完全な解答は巻末にあります。
A newly hired nurse had BCG vaccine as a child. Which TB screening test is usually preferred?
A patient on an anticoagulant falls and hits their head but says they feel fine. What should the nurse do?
At what angle is a subcutaneous injection usually given?
A healthcare assistant (nursing assistant) has recorded a blood pressure of 82/50 mmHg during routine observations but did not report it. What should the registered nurse do first?
弱毒化した生ウイルスを含むワクチンはどれですか？
咽頭痛、発熱、リンパ節腫脹のある若い成人にアモキシシリンを投与したところ、広範な発疹が出ました。最も可能性が高い感染症はどれですか？
答え: D · An interferon-gamma release assay (IGRA) blood test
BCG vaccine can cause a false-positive tuberculin skin test. IGRA blood tests are not affected by BCG, so they are preferred for people who have had the vaccine.
答え: B · Notify the provider and start neurological observations, because a brain bleed may develop
Head injury in a patient on anticoagulants can cause bleeding inside the skull that shows signs later. The provider is told at once, imaging may be needed and neurological checks are done closely.
答え: D · 45 to 90 degrees, depending on the amount of fat
The angle depends on needle length and body fat. A short needle at 90 degrees suits most adults; in thin patients a pinch of skin or a 45-degree angle avoids reaching muscle.
答え: C · Assess the patient straight away
A low blood pressure may mean deterioration, so the nurse assesses the patient at once and escalates if needed. Feedback to the assistant and reporting follow afterwards.
答え: C · MMR（麻疹・おたふくかぜ・風疹）
MMR は少しだけ複製する弱毒化した生ウイルスを含み、強く長く続く免疫を与えます。破傷風はトキソイド、B 型肝炎はサブユニットワクチンです。
答え: C · EB ウイルスによる伝染性単核球症
伝染性単核球症は EBV が原因です。病気の間にアモキシシリンを投与された患者の多くに発疹が出ます。原因はウイルスなので、抗生物質は役に立ちません。
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