内科外科看護：直前対策パック

How should a patient breathe in when using a dry powder inhaler?

1. AQuickly and deeply, after breathing out away from the device
2. BThrough the nose with the mouthpiece in the mouth
3. CSlowly and gently over about ten seconds
4. DSeveral times, breathing out into the device between breaths

A patient with stable severe COPD has a blood gas showing pH 7.37, a raised PaCO₂ and a raised bicarbonate. How should this be interpreted?

1. ARespiratory alkalosis from hyperventilation
2. BA normal blood gas with no abnormality
3. CAcute respiratory acidosis needing emergency intubation
4. DChronic respiratory acidosis with metabolic compensation

下垂体手術の後、患者が3時間にわたって1時間に400 mLの尿を出し、比重が低くなっています。看護師は何を疑うべきですか？

1. A急性腎障害
2. BSIADH
3. C尿崩症
4. D正常な利尿

The nurse has four patients with diabetes. Which one needs to be seen first?

1. AA newly diagnosed patient asking about which foods to eat
2. BA patient waiting for a routine HbA1c test
3. CA patient with a glucose of 14 mmol/L (252 mg/dL) who feels well and is eating
4. DA patient with a glucose of 2.8 mmol/L (50 mg/dL) who is sweaty and confused

Why is IV albumin often given after a large-volume paracentesis?

1. ATo replace the clotting factors and platelets lost in the drained fluid
2. BTo prevent low blood pressure and kidney injury from fluid shifts
3. CTo raise the blood glucose after the procedure
4. DTo treat infection in the ascitic fluid

A few hours after thyroid surgery, a patient's neck swells rapidly and they become short of breath with stridor. What is most likely?

1. ANormal swelling after neck surgery
2. BLow blood calcium from the surgery
3. CA haematoma pressing on the airway
4. DAn allergy to the wound dressing

Which of these is a non-drug measure that can help relieve pain?

1. ARestricting visitors completely
2. BKeeping the patient awake all night
3. CRepositioning and distraction
4. DTelling the patient that the pain is not real

A seriously ill patient asks the nurse, "Am I dying?" What is the best initial response?

1. ATell the patient not to think about such things and to stay positive
2. BLeave and send the doctor without saying anything
3. CChange the subject quickly to keep them cheerful and avoid upsetting them
4. DGently explore what the patient understands and what has prompted the question

A patient on a heparin infusion has an aPTT below the target range on the protocol. What should the nurse do?

1. ASwitch the infusion to oral warfarin without a prescription
2. BStop the infusion and give protamine sulfate as quickly as possible
3. CContinue the same rate and recheck the aPTT in a few days
4. DAdjust the rate as the protocol directs and recheck as scheduled

長年の肺疾患がある患者の血清重炭酸が 32 mEq/L、動脈血 PaCO₂ が常に高く、pH が 7.36 です。最もよく合う病態はどれですか？

1. A呼吸が速くなる急性のアスピリン過量服用
2. B重度の脱水と嘔吐を伴う急性の糖尿病性ケトアシドーシス
3. C重炭酸が大量に失われる急性の重度の下痢
4. D慢性の CO₂ 貯留と代謝性代償を伴う COPD

練習用の血液ガスで、PaCO₂ は 22 mmHg (2.9 kPa) です。慢性呼吸性アルカローシスでは、PaCO₂ が 40 mmHg を 10 mmHg 下回るごとに HCO₃⁻ は 5 mmol/L 低下します という規則を使い、HCO₃⁻ 24 mmol/L から出発して、期待される HCO₃⁻ を求めてください。

練習用の血液ガスは代謝性アシドーシスを示しています：pH は 7.17、PaCO₂ は 37 mmHg (4.9 kPa)、HCO₃⁻ は 13 mmol/L です。測定した PaCO₂ をウィンターの式と比べてください。あなたの解釈をクリックしてください。

1. 1適切な代償
2. 2呼吸性アシドーシスの合併
3. 3呼吸性アルカローシスの合併

この整なII誘導のストリップで QT 間隔と R–R 間隔を測定し、Bazett の式 QTc = QT/√RR（どちらも秒）で心拍数補正した QTc を計算してください。答えは秒単位で小数第3位まで求めてください。

このII誘導のストリップを、5つのステップ（心拍数、リズム、P波、PR 間隔、QRS 幅）の順に解釈してください。最初の異常所見はどのステップで見つかりますか。それをクリックしてください。

1. 1償却率
2. 2リズム
3. 3P波
4. 4PR 間隔
5. 5QRS 幅

A swimmer is found unresponsive after diving into shallow water. Which method should the nurse use to open the airway?

1. AHead-tilt, chin-lift with full neck extension
2. BRaising the chin while bending the neck forward
3. CJaw thrust, keeping the head and neck in line
4. DTurning the head to the side to drain water

During surgery under general anesthesia, a patient develops rising end-tidal carbon dioxide, muscle rigidity and a rapidly increasing temperature. Which drug should the nurse anticipate?

1. ANaloxone
2. BDantrolene
3. CAtropine
4. DFlumazenil