1.やさしい
What does a positive tuberculin skin test or interferon-gamma release assay show?
- AThat the patient has never met TB
- BActive, infectious TB of the lungs that needs isolation now
- CInfection with TB at some time, not necessarily active disease
- DComplete, lifelong immunity to TB after a previous vaccine
2.やさしい
Which of these is a modifiable risk factor for coronary heart disease?
- ASmoking
- BMale sex
- CFamily history
- DOlder age
3.やさしい
What causes the first heart sound (S1)?
- ABlood flowing quickly into the atria
- BClosure of the mitral and tricuspid valves
- CThe heart muscle stretching in diastole
- DClosure of the aortic and pulmonary valves
4.ふつう
A patient who had a stroke has a weak swallow. Which measure most reduces the risk of aspiration pneumonia?
- AGiving thin fluids quickly through a straw between meals
- BGiving meals while the patient is drowsy
- CLying flat for 30 minutes after eating to aid digestion
- DA swallowing assessment and sitting upright for meals
5.ふつう
A nurse measures blood pressure on a large upper arm using a cuff that is too small. What effect will this have?
- AOnly the pulse rate will be affected
- BThe reading will be falsely low
- CThe reading will be falsely high
- DThe reading will be accurate but slower
6.ふつう
胸腔ドレーンの液面が、動かなくなりました。何が考えられますか?
- Aドレナージユニットが腹部の排液を始めた
- B肺が再膨張したか、チューブが折れ曲がっているか閉塞している
- C反対側に新たな気胸が起きた
- D室内の水位が高すぎて動けなくなった
7.むずかしい
Minutes after an IV antibiotic is started, a patient has wheeze, swollen lips, a rash and BP 78/44 mmHg. The infusion has been stopped and help called. What is the next priority?
- AGive a nebulised salbutamol dose only
- BRestart the infusion at a slower rate
- CGive intramuscular adrenaline (epinephrine)
- DGive an oral antihistamine tablet and observe for an hour
8.むずかしい
Three days after an MI, a patient faints on the commode while straining hard to open the bowels. The heart rate was 42/min at the time. What is the most likely mechanism?
- AA new pulmonary embolism
- BAn allergic reaction to the commode
- CA vagal response to straining
- DLow blood glucose from fasting
解答
- 1. C · Infection with TB at some time, not necessarily active disease
- 2. A · Smoking
- 3. B · Closure of the mitral and tricuspid valves
- 4. D · A swallowing assessment and sitting upright for meals
- 5. C · The reading will be falsely high
- 6. B · 肺が再膨張したか、チューブが折れ曲がっているか閉塞している
- 7. C · Give intramuscular adrenaline (epinephrine)
- 8. C · A vagal response to straining
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