1.やさしい
Where does most of the ammonia in the blood come from, and which organ removes it?
- AFat breakdown in adipose tissue; removed by the lungs
- BGlucose breakdown in muscle; removed by the pancreas
- CRed cell breakdown in the spleen; removed by the skin
- DProtein breakdown by gut bacteria; removed by the liver
2.やさしい
Which fasting triglyceride level is commonly described as normal?
- AAbove 500 mg/dL (5.6 mmol/L)
- BBelow 150 mg/dL (1.7 mmol/L)
- CAbove 1,000 mg/dL (11.3 mmol/L)
- DBetween 200 and 499 mg/dL (2.3–5.6 mmol/L)
3.やさしい
What does normal cerebrospinal fluid (CSF) look like?
- AClear and colorless
- BPink and bloody
- CCloudy and yellow
- DThick and green
4.ふつう
An older adult with chronic kidney disease starts trimethoprim-sulfamethoxazole for a urinary tract infection. Which electrolyte should be monitored closely?
- AChloride, because the drug causes chloride loss
- BSodium, because the drug causes heavy sodium retention
- CCalcium, because the drug binds calcium in the gut
- DPotassium, because trimethoprim can raise it
5.ふつう
A patient on warfarin has an INR of 7.8 and a nosebleed. Which medication would the nurse expect the provider to prescribe?
- ANaloxone hydrochloride
- BAcetylcysteine
- CProtamine sulfate
- DVitamin K (phytonadione)
6.ふつう
A nurse completed the hepatitis B vaccine series. Which result shows protective immunity?
- AA positive IgM anti-HBc
- BA positive HBsAg test
- CAnti-HBs of 10 mIU/mL or more
- DA raised ALT level
7.むずかしい
リチウム濃度 1.0 mEq/L が、患者の朝の服用の 2 時間後に採血され、処方者は用量を増やそうとしています。看護師は何を指摘すべきですか?
- A検体が服用から早すぎる時点で採取されたため、有効な濃度ではない
- B濃度は中毒域なので、リチウムを永久に中止すべきである
- Cリチウム濃度は、結果に影響することなく、1 日のうちいつでも採血できる
- D濃度が低すぎるので、大幅な増量は明らかに安全である
8.むずかしい
A patient on stable digoxin starts amiodarone. A week later, the patient has nausea and visual changes, and the digoxin level is above the range. What is the most likely explanation?
- AAmiodarone has raised the digoxin level
- BAmiodarone has lowered potassium only
- CDigoxin has raised the amiodarone level
- DThe patient has started a viral illness
解答
- 1. D · Protein breakdown by gut bacteria; removed by the liver
- 2. B · Below 150 mg/dL (1.7 mmol/L)
- 3. A · Clear and colorless
- 4. D · Potassium, because trimethoprim can raise it
- 5. D · Vitamin K (phytonadione)
- 6. C · Anti-HBs of 10 mIU/mL or more
- 7. A · 検体が服用から早すぎる時点で採取されたため、有効な濃度ではない
- 8. A · Amiodarone has raised the digoxin level
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