1.やさしい
A raised alkaline phosphatase (ALP) is most typical of:
- AAcute damage to the heart muscle
- BBlocked bile flow or increased bone turnover
- CLow production of hormone by the thyroid gland
- DInflammation of the lining of the urinary bladder
2.やさしい
A patient on warfarin asks what an INR of 2.0 means. Which explanation is best?
- AYour blood clots about twice as fast as is normal
- BYour warfarin dose is twice what it should be
- CYour blood takes about twice as long as normal to clot
- DYou have twice the normal number of platelets
3.やさしい
Where does most of the ammonia in the blood come from, and which organ removes it?
- AGlucose breakdown in muscle; removed by the pancreas
- BFat breakdown in adipose tissue; removed by the lungs
- CProtein breakdown by gut bacteria; removed by the liver
- DRed cell breakdown in the spleen; removed by the skin
4.ふつう
A patient on hemodialysis has an arteriovenous (AV) fistula in the left arm. Where should the nurse draw routine blood samples?
- AFrom the right arm
- BFrom the fistula
- CFrom the left wrist
- DFrom the left hand
5.ふつう
A patient scheduled for surgery this morning has a potassium of 3.0 mEq/L on pre-operative tests. What should the nurse do?
- AReport it to the surgical team before surgery
- BGive an oral potassium dose without a prescription
- CSend the patient to surgery without comment
- DRepeat the test after the surgery is finished
6.ふつう
A patient takes low-dose methotrexate weekly for rheumatoid arthritis. Which laboratory tests are monitored regularly?
- ASerum lithium, sodium and urine specific gravity
- BComplete blood count, liver tests and kidney function
- CSerum amylase, lipase and blood ketones
- DTroponin, creatine kinase and myoglobin
7.むずかしい
血小板数が 35 × 10³/µL の患者に、筋肉内注射が処方されました。看護師はどうすべきですか?
- A処方どおりに注射し、部位を強くマッサージする
- B注射して、温罨法を当てる
- Cより長い針で注射する
- Dほかの経路を使えないか、処方者に確認する
8.むずかしい
A patient with chronic kidney disease stage 4 has a high phosphate, a low-normal calcium and a very high parathyroid hormone (PTH). What does this show?
- ASecondary hyperparathyroidism from CKD
- BPrimary hyperparathyroidism from a tumor
- CVitamin D toxicity from supplements
- DHypoparathyroidism after neck surgery
解答
- 1. B · Blocked bile flow or increased bone turnover
- 2. C · Your blood takes about twice as long as normal to clot
- 3. C · Protein breakdown by gut bacteria; removed by the liver
- 4. A · From the right arm
- 5. A · Report it to the surgical team before surgery
- 6. B · Complete blood count, liver tests and kidney function
- 7. D · ほかの経路を使えないか、処方者に確認する
- 8. A · Secondary hyperparathyroidism from CKD
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