A collapsed patient is unresponsive and making only occasional slow gasps. What should the nurse do?
APlace the patient in the recovery position and keep observing them
BTreat it as not breathing normally, call for help and start CPR
CGive a sip of water to clear the throat
DWait to see whether the gasps become regular
3.感染管理と患者の安全ふつう
滅菌手袋を装着するとき、看護師は2枚目の手袋をどのようにはめますか?
A手袋をはめた指を2枚目の手袋のカフの下に滑り込ませて引き上げる
B素手で指先をつまんで2枚目の手袋を引き上げる
C手袋をはめた手で2枚目の手袋の内側を持つ
D素手で1枚目の手袋の外側を整える
4.感染管理と患者の安全むずかしい
A patient with pulmonary tuberculosis has been on treatment. Which findings usually allow airborne isolation to end?
AThree negative sputum smears, clinical improvement and continued therapy
BThe cough has stopped, even with no sputum tests
COne negative chest x-ray after starting treatment
DThe patient has been in hospital for one week and has taken every dose of medicine
5.優先順位の決定と委任ふつう
A nasogastric tube has just been placed for feeding. What must happen before the first feed is given?
AThe tube is flushed with a large volume of water
BThe feed is started slowly to see if the patient coughs
CThe patient is asked if the tube feels comfortable
DPlacement is confirmed by an approved method
6.優先順位の決定と委任むずかしい
A patient admitted with suspected appendicitis says the pain suddenly got better, but now the abdomen is rigid and the heart rate is rising. What does this suggest?
AThe pain has moved to a different, harmless place
BThe appendix may have ruptured, causing peritonitis
CThe patient’s analgesic has finally started to work
DThe appendicitis is getting better without surgery
7.臨床看護学ふつう
Why does a patient with a suspected TIA need urgent specialist assessment?
AThe patient needs urgent surgery on the brain
BThe symptoms will come back permanently within an hour
CA TIA always turns into a brain tumour unless it is treated
DThe risk of a full stroke is highest in the days after a TIA
8.臨床看護学むずかしい
A patient with a confirmed pulmonary embolism is started on anticoagulation. Which statement best explains its purpose?
AIt stops the clot growing and prevents new clots while the body breaks it down
BIt thins the blood so that the lungs absorb more oxygen
CIt is mainly given to lower the blood pressure
DIt dissolves the clot completely within minutes of the first dose being given
A child with nephrotic syndrome develops a painful, swollen leg. What should the nurse suspect?
AAn allergic reaction to steroids
BA muscle strain from walking
COrdinary oedema from the illness
DDeep vein thrombosis
23.精神看護ふつう
Which tool is widely used to screen for delirium at the bedside?
AThe CAGE questionnaire
BThe CIWA-Ar
CThe Confusion Assessment Method (CAM)
DThe Abnormal Involuntary Movement Scale (AIMS)
24.精神看護むずかしい
After witnessing a serious accident, a woman suddenly cannot move her legs. Full investigations are normal. Which nursing approach is most appropriate?
AAccept that the symptom is real for her, help with mobility needs and gently explore recent stress
BIgnore her requests for help completely until she agrees to try to walk again on her own
CTell her that the paralysis is fake and that she should stand up
DFocus every conversation on the details of her leg weakness
25.看護の計算と単位換算ふつう
練習問題(数値は架空のもので、臨床上の指針ではありません)。 ある患者の体温は 35.9 °C です。°F = °C × 9/5 + 32 を使って華氏 T に換算してください。小数第1位に丸めてください。
答え: B · Treat it as not breathing normally, call for help and start CPR
これが答えになる理由
Agonal gasps are common in the first minutes after cardiac arrest. They must not be mistaken for breathing; CPR is started and an AED fetched straight away.
答え
B · Treat it as not breathing normally, call for help and start CPR
答え: A · Three negative sputum smears, clinical improvement and continued therapy
これが答えになる理由
Airborne precautions usually continue until the patient is on effective therapy, is improving clinically and has three negative sputum smears for acid-fast bacilli, according to policy.
答え
A · Three negative sputum smears, clinical improvement and continued therapy
5.優先順位の決定と委任
答え: D · Placement is confirmed by an approved method
これが答えになる理由
A newly placed feeding tube can enter the airway without obvious symptoms, so placement is confirmed before anything is given. Methods differ: US practice usually requires an X-ray for a new feeding tube, while UK guidance uses aspirate pH testing (5.5 or below) first, with X-ray if that fails. Air “whoosh” tests and waiting for coughing are not reliable.
答え
D · Placement is confirmed by an approved method
6.優先順位の決定と委任
答え: B · The appendix may have ruptured, causing peritonitis
これが答えになる理由
A sudden ease in pain followed by a rigid abdomen and a rising pulse can mean rupture and peritonitis. This is a surgical emergency, so the nurse reports at once.
答え
B · The appendix may have ruptured, causing peritonitis
7.臨床看護学
答え: D · The risk of a full stroke is highest in the days after a TIA
これが答えになる理由
The risk of stroke is highest soon after a TIA. Rapid assessment and treatment, such as antiplatelets, statins and carotid imaging, reduce this risk.
答え
D · The risk of a full stroke is highest in the days after a TIA
8.臨床看護学
答え: A · It stops the clot growing and prevents new clots while the body breaks it down
これが答えになる理由
Anticoagulants prevent clot extension and new clots; the body's own fibrinolysis gradually breaks down the existing clot. Thrombolysis, which actively dissolves clots, is reserved for massive PE with shock.
答え
A · It stops the clot growing and prevents new clots while the body breaks it down
答え: D · Limit coffee, tea and cola, because caffeine adds to the side effects
これが答えになる理由
Theophylline has a narrow therapeutic range, and caffeine adds stimulant effects such as tachycardia, restlessness and insomnia. Toxicity can cause arrhythmias and seizures, so blood levels may be monitored.
答え
D · Limit coffee, tea and cola, because caffeine adds to the side effects
12.薬理学
答え: D · Stevens–Johnson syndrome; stop the drug and get urgent medical care
これが答えになる理由
Stevens–Johnson syndrome is a severe drug reaction with skin blistering and mucosal involvement. Sulfonamides are a common cause, and the drug must be stopped immediately.
答え
D · Stevens–Johnson syndrome; stop the drug and get urgent medical care
13.内科外科看護:循環器と呼吸器
答え: C · Checking leg pulses, colour, warmth and sensation
これが答えになる理由
After aortic surgery, distal pulses, skin colour, temperature, capillary refill, movement and sensation are checked often and compared with baseline. Loss of pulses, pallor or pain suggests graft occlusion or emboli and must be reported at once. Urine output is also monitored for renal perfusion.
答え
C · Checking leg pulses, colour, warmth and sensation
14.内科外科看護:循環器と呼吸器
答え: A · A patient who had a brain haemorrhage two days ago
これが答えになる理由
When bleeding risk is high, such as after recent intracranial haemorrhage, mechanical methods (intermittent pneumatic compression) are used instead of anticoagulants until it is safe. The other patients are at high VTE risk and would usually receive pharmacological prophylaxis unless contraindicated.
答え
A · A patient who had a brain haemorrhage two days ago
答え: B · Give IV antibiotics at once and start sepsis treatment
これが答えになる理由
Meningococcal septicaemia can kill within hours. Antibiotics must not be delayed for a lumbar puncture or scan. Fluids and other sepsis care are started, and a lumbar puncture is often unsafe in a shocked patient.
答え
B · Give IV antibiotics at once and start sepsis treatment
答え: C · Limit plain drinks and use an oral rehydration solution
これが答えになる理由
In high-output stomas, hypotonic drinks increase sodium loss through the stoma. Restricting them and using a glucose–salt oral rehydration solution, with antimotility drugs as prescribed and medical review, helps correct dehydration.
答え
C · Limit plain drinks and use an oral rehydration solution
19.母性看護・産科看護
答え: A · Full flexion, with the chin on the chest
これが答えになる理由
When the head is fully flexed, the suboccipitobregmatic diameter of about 9.5 cm presents. Extension, as in brow and face presentations, presents larger diameters and can obstruct labour.
答え
A · Full flexion, with the chin on the chest
20.母性看護・産科看護
答え: C · It is a screening test, so a diagnostic test is offered to confirm it
これが答えになる理由
Cell-free DNA testing analyses placental DNA in the mother's blood. It is very accurate but remains a screening test, so a high-chance result is confirmed by chorionic villus sampling or amniocentesis.
答え
C · It is a screening test, so a diagnostic test is offered to confirm it
Nephrotic syndrome causes a hypercoagulable state through loss of anticoagulant proteins, raised clotting factors and haemoconcentration. A painful, swollen limb suggests thrombosis and needs urgent medical review.
答え
D · Deep vein thrombosis
23.精神看護
答え: C · The Confusion Assessment Method (CAM)
これが答えになる理由
The CAM checks for acute onset and fluctuating course, inattention, and either disorganised thinking or an altered level of consciousness. Other tools, such as the 4AT, are also used.
答え
C · The Confusion Assessment Method (CAM)
24.精神看護
答え: A · Accept that the symptom is real for her, help with mobility needs and gently explore recent stress
これが答えになる理由
In conversion disorder, the symptom is real to the patient and is not faked. The nurse meets physical needs, avoids reinforcing the symptom through excessive attention, and supports the patient in talking about stress and feelings.
答え
A · Accept that the symptom is real for her, help with mobility needs and gently explore recent stress
25.看護の計算と単位換算
答え: T = 96.6 °F
温度:°C = (°F − 32) × 5/9、°F = °C × 9/5 + 32。°F から変換するときは、掛ける前に32を引きます。°C から変換するときは、掛けた後に32を足します。簡単な確認:37 °C は 98.6 °F で、1 °C ごとに 1.8 °F です。
9/5を掛ける
35.9·9/5 = 64.62
32を足す
T = 64.62 + 32 = 96.62 ≈ 96.6 °F
答え
T = 96.6 °F
26.看護の計算と単位換算
答え: c = 354 µmol/L
次元解析:与えられた量を書き、それに分数で表した換算係数(例:60 min/1 h や 1 mg/1000 mcg)を掛けていきます。不要な単位が分子と分母に1回ずつ現れて約分されるようにします。求める単位だけが残ったら計算します。問題で与えられた換算値を使い、丸めるのは最終的な答えだけです。
変換
c = 4·88.4 = 353.6 ≈ 354 µmol/L
答え
c = 354 µmol/L
27.投与量の計算
答え: V = 1.5 mL
Dose calculation: the amount to give equals what is prescribed divided by what you have, times the quantity it comes in: amount = (desired dose/stock strength) × stock volume. Always keep the units the same (convert g to mg, mg to mcg first) and check that the answer is sensible.
混合後の濃度
1000 mg/10 mL = 100 mg/mL
体積
V = 150/100 = 1.5 mL
答え
V = 1.5 mL
28.投与量の計算
答え: V₁ = 50 mL
Solution strengths: a percentage strength is grams per 100 mL, so 1% = 1 g/100 mL = 10 mg/mL. A ratio strength 1:1000 means 1 g in 1000 mL = 1 mg/mL; 1:10 000 is 0.1 mg/mL. For a dilution the amount of drug stays the same: C₁·V₁ = C₂·V₂.
Dose-based infusions: concentration = amount of drug in the bag/bag volume. Pump rate (mL/h) = dose per hour/concentration, and dose per hour = mL/h × concentration. Convert per-minute doses to per-hour (× 60) and keep the mass units the same (1 g = 1000 mg, 1 mg = 1000 mcg).
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