1.やさしい
How does montelukast work in asthma?
- AIt blocks leukotriene receptors in the airways
- BIt stimulates beta-2 receptors in the airways
- CIt kills bacteria in the bronchi
- DIt thins mucus by breaking down DNA
2.やさしい
What is Cheyne–Stokes breathing?
- ACycles of deeper then shallower breaths followed by a pause
- BBreathing only through pursed lips
- CA harsh, high-pitched sound on breathing in through the throat
- DConstant deep, fast breathing that never changes in depth
3.やさしい
Which drug reverses the effect of unfractionated heparin?
- AFlumazenil
- BProtamine sulfate
- CVitamin K (phytomenadione)
- DNaloxone
4.ふつう
アピキサバンやリバーロキサバンなどの直接作用型経口抗凝固薬(DOAC)について正しい記述はどれですか?
- A定期的なINR検査は不要だが、用量は腎機能に依存する
- B数週間作用するため、飲み忘れても問題ない
- Cワルファリンと同様に、毎週のINR検査が必要である
- DビタミンKを投与すると作用が打ち消される
5.ふつう
What is the purpose of cardiac resynchronisation therapy (a biventricular pacemaker)?
- ATo slow the atrial rate in patients with atrial fibrillation
- BTo make both ventricles contract together and more efficiently
- CTo deliver a shock whenever the heart rate exceeds 100/min
- DTo replace a damaged heart valve
6.ふつう
Unless fluids are restricted, why are patients with pneumonia encouraged to drink plenty?
- ATo lower the temperature by diluting the blood plasma
- BTo make the cough completely stop
- CTo prevent dehydration and keep secretions thinner
- DTo flush the bacteria out through the urine
7.むずかしい
A nurse receives handover on four patients. Which patient should be seen first?
- AA patient on day 1 after surgery who is newly restless, RR 30/min, SpO₂ 88% on 4 L/min
- BA patient with COPD on 1 L/min whose SpO₂ has been 89% and stable throughout the night
- CA patient with asthma who wants a reliever inhaler before a walk
- DA patient with pneumonia on IV antibiotics who now has a temperature of 38.2 °C
8.むずかしい
A patient declines enoxaparin for VTE prevention because it is made from pork, which conflicts with their beliefs. What is the best response?
- ATell the patient that refusal means they cannot have surgery
- BRespect the decision, inform the prescriber and discuss non-animal options
- CGive the injection anyway without explaining what the medicine is made from
- DDocument the refusal in the notes and take no further action at all
解答
- 1. A · It blocks leukotriene receptors in the airways
- 2. A · Cycles of deeper then shallower breaths followed by a pause
- 3. B · Protamine sulfate
- 4. A · 定期的なINR検査は不要だが、用量は腎機能に依存する
- 5. B · To make both ventricles contract together and more efficiently
- 6. C · To prevent dehydration and keep secretions thinner
- 7. A · A patient on day 1 after surgery who is newly restless, RR 30/min, SpO₂ 88% on 4 L/min
- 8. B · Respect the decision, inform the prescriber and discuss non-animal options
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