During adult cardiac arrest, how often is IV adrenaline (epinephrine) usually repeated?
AEvery 15–20 minutes
BEvery 3–5 minutes
COnce only, at the start
DEvery 30 seconds
12.薬理学むずかしい
A patient with asthma starts timolol eye drops for glaucoma and soon becomes wheezy. What is the most likely explanation?
AThe eye drops contain an allergen that causes hay fever and asthma
BTimolol is absorbed and blocks beta-2 receptors in the airways
CTimolol activates histamine receptors in the lungs
DThe wheeze is unrelated to the eye drops
13.内科外科看護:循環器と呼吸器ふつう
A patient choosing between a mechanical and a biological heart valve asks about the main difference. Which answer is accurate?
AMechanical valves last longer but need lifelong anticoagulation
BBiological valves last longer but need lifelong warfarin
CBoth types need no medicines after surgery
DMechanical valves wear out within one year
14.内科外科看護:循環器と呼吸器むずかしい
A patient with both COPD and heart disease is more breathless, with bilateral basal crackles, raised JVP, ankle swelling and a markedly raised NT-proBNP. Which problem is most likely driving this episode?
AAn asthma attack
BDecompensated heart failure
CA primary spontaneous pneumothorax
DHyperventilation from anxiety
15.内科外科看護:神経、内分泌、腎臓ふつう
Why are tacrolimus blood levels checked regularly?
AThe drug only works if levels are as high as possible
BThe levels show how much urine the kidney is making
CToo high harms the kidney; too low risks rejection
答え: B · The first urine of the morning is discarded and the time noted, then all urine is kept
これが答えになる理由
The patient empties the bladder at the start and that urine is discarded. All urine for the next 24 hours is kept, including a final void at the end time.
答え
B · The first urine of the morning is discarded and the time noted, then all urine is kept
答え: C · Whether the patient has any metal implants or devices, such as a pacemaker
これが答えになる理由
The MRI magnet can move or heat metal objects and can stop some implanted devices from working. Patients are screened for implants, pacemakers, metal fragments and metal items such as jewelry before entering the scanner room.
答え
C · Whether the patient has any metal implants or devices, such as a pacemaker
4.感染管理と患者の安全
答え: C · Use an electronic wander alert, supervise closely and offer meaningful activity
これが答えになる理由
Wander alert systems, close supervision, orientation and activity reduce the risk of elopement without restricting the patient. Seclusion, restraints and sedation used for convenience are not appropriate.
答え
C · Use an electronic wander alert, supervise closely and offer meaningful activity
答え: A · Report it to the nurse manager according to policy
これが答えになる理由
Suspected drug diversion must be reported through the proper channel, usually the manager. It protects patients and allows the colleague to get help; staying silent is not acceptable.
答え
A · Report it to the nurse manager according to policy
7.臨床看護学
答え: A · Breathing function, such as forced vital capacity
これが答えになる理由
Guillain–Barré syndrome can paralyse the respiratory muscles. Serial vital capacity measurements help identify patients who need ventilation before they deteriorate.
答え
A · Breathing function, such as forced vital capacity
8.臨床看護学
答え: C · 速やかに隔離し、接触予防策をとり、便検体を提出する
これが答えになる理由
原因不明の下痢は、例えば C. difficile やノロウイルスによる感染性のことがあります。遅れずに隔離と検査を行うことで、ほかの患者を守ります。
答え
C · 速やかに隔離し、接触予防策をとり、便検体を提出する
9.検査値と電解質
答え: D · The inflammation is settling with treatment
これが答えになる理由
CRP has a short half-life of about 19 hours, so it falls within days when inflammation is controlled. A falling CRP, together with clinical improvement, supports a response to treatment; a CRP that stays high or rises again needs review.確認に用いた資料:C-reactive protein · MedlinePlus (NIH) (2025)
In adult advanced life support, adrenaline 1 mg IV or IO is repeated every 3–5 minutes during the arrest. High-quality CPR and defibrillation for shockable rhythms remain the priorities.
答え
B · Every 3–5 minutes
12.薬理学
答え: B · Timolol is absorbed and blocks beta-2 receptors in the airways
これが答えになる理由
Ophthalmic timolol is a non-selective beta blocker and can reach the circulation in amounts that cause bronchospasm or bradycardia. It is generally avoided in asthma.
答え
B · Timolol is absorbed and blocks beta-2 receptors in the airways
13.内科外科看護:循環器と呼吸器
答え: A · Mechanical valves last longer but need lifelong anticoagulation
これが答えになる理由
Mechanical valves are very durable but are thrombogenic, so lifelong warfarin is needed. Biological (tissue) valves usually do not need long-term anticoagulation but wear out over time and may need replacement. Age, lifestyle and bleeding risk guide the choice.
答え
A · Mechanical valves last longer but need lifelong anticoagulation
14.内科外科看護:循環器と呼吸器
答え: B · Decompensated heart failure
これが答えになる理由
Basal crackles, raised JVP, oedema and a high natriuretic peptide point to heart failure rather than a COPD exacerbation alone. Distinguishing them matters, because treatment (diuretics and HF drugs versus bronchodilators and steroids) is different. Both may occur together.
答え
B · Decompensated heart failure
15.内科外科看護:神経、内分泌、腎臓
答え: C · Too high harms the kidney; too low risks rejection
これが答えになる理由
Tacrolimus has a narrow therapeutic range and many interactions. High levels can cause nephrotoxicity, tremor and high glucose, while low levels risk rejection. Trough levels are taken before the morning dose.
答え
C · Too high harms the kidney; too low risks rejection
答え: A · "Severe abdominal pain is normal for a week afterwards."
これが答えになる理由
Mild bloating and cramps from the air used are expected. Severe or worsening pain, fever, a distended abdomen or heavy rectal bleeding can mean perforation or haemorrhage and must be reported straight away.
答え
A · "Severe abdominal pain is normal for a week afterwards."
19.母性看護・産科看護
答え: D · Suboptimal intake jaundice
これが答えになる理由
Early jaundice with poor intake is linked to insufficient milk, which slows stooling and increases reabsorption of bilirubin. Support with frequent effective feeds is the main treatment.
答え: A · Keep the child calm and upright, and get urgent help if there is noisy breathing at rest
これが答えになる理由
Calm and comfort reduce distress and airway narrowing. Steam inhalation is not effective and risks scalds. Parents should seek urgent help for stridor at rest, retractions, drooling, blue colour or drowsiness.
答え
A · Keep the child calm and upright, and get urgent help if there is noisy breathing at rest
22.小児看護
答え: A · "I'll put a spoon in his mouth so he doesn't bite or swallow his tongue."
これが答えになる理由
Putting objects in the mouth can break teeth, injure the mouth or block the airway; the tongue cannot be swallowed. Timing the seizure, protecting from injury and placing the child on the side afterwards are correct.
答え
A · "I'll put a spoon in his mouth so he doesn't bite or swallow his tongue."
23.精神看護
答え: D · Fasting for several hours, because a brief general anaesthetic is given
これが答えになる理由
ECT is given under brief general anaesthesia with a muscle relaxant, so pre-procedure fasting is needed. Vital signs, consent and removal of dentures, jewellery and nail varnish are checked as per policy.
答え
D · Fasting for several hours, because a brief general anaesthetic is given
24.精神看護
答え: B · Protect the airway and keep him safe from injury
これが答えになる理由
During a seizure, the nurse protects the airway, removes nearby hazards, does not restrain or put anything in the mouth, and calls for help. Alcohol withdrawal seizures are most likely in the first 48 hours.
答え
B · Protect the airway and keep him safe from injury
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。
換算の連鎖を立てる
D = 0.5 mg/h × (1000 mcg/1 mg) × (1 h/60 min)
計算する
D = 500/60 = 8.333 ≈ 8.3 mcg/min
答え
D = 8.3 mcg/min
27.投与量の計算
答え: V = 0.8 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.
Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.
流量(mL/h)
30·60/15 = 120 mL/h
体積
V = 120·12 = 1440 mL
答え
V = 1440 mL
30.点滴速度
答え: Δ = 14.67 %
Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.
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