1.やさしい
A patient changes quickly from crying to laughing and back again within a few minutes, without an obvious reason. How is this affect described?
- AFlat
- BBlunted
- CCongruent
- DLabile
2.やさしい
A patient says, "If I make one mistake at work, I'll be fired, lose my flat and end up on the street." Which cognitive distortion is this?
- AMind reading
- BCatastrophising
- CPersonalisation
- DEmotional reasoning
3.やさしい
A patient believes that the newsreader on television is sending him personal messages. What is this called?
- AA somatic delusion
- BThought insertion
- CAn illusion
- DAn idea of reference
4.ふつう
A teenager is starting atomoxetine for ADHD. What should the nurse teach the family to watch for?
- ASigns of physical dependence, because it is a controlled stimulant
- BA dangerous rise in blood pressure after eating foods that contain tyramine
- CNew or worsening suicidal thoughts or unusual changes in mood or behaviour
- DSevere weight gain in the first week
5.ふつう
How does repetitive transcranial magnetic stimulation (rTMS) differ from ECT?
- AIt uses magnetic pulses on the scalp while the patient is awake, without causing a seizure
- BIt is given as a daily tablet that contains tiny magnetic particles
- CIt involves surgically implanting electrodes deep in the brain under anaesthetic
- DIt needs a general anaesthetic and causes a seizure, like ECT
6.ふつう
How should a patient with anorexia nervosa be weighed in hospital?
- AAt the same time, on the same scale, in a gown, after emptying the bladder
- BOnly when she asks to be weighed, to respect her wishes
- CAt a different time each day so that she cannot prepare for it
- DIn her own clothes and shoes after breakfast, so that she feels more comfortable
7.むずかしい
パニック障害と診断されている患者が、胸痛と呼吸困難を訴えています。看護師が最初にすべきことは何ですか?
- Aパニックと決めつける前に、バイタルサインを含めて身体的にアセスメントし、方針に従って心電図を記録する
- Bパニック障害ではいつもおさまるのだから、紙袋の中でゆっくり呼吸するよう頼み、おさまるまでそっとしておく
- C認知の再構成について講義をする
- Dただのパニック発作だと伝える
8.むずかしい
最後の飲酒から 2 日目に、患者に著明な振戦があり、壁に虫が見え、心拍数 124 回/分、血圧 170/100 mmHg、大量の発汗がみられます。優先すべきことは何ですか?
- A虫は現実ではないと説明し、休ませておく
- B症状を鎮めるために少量のアルコールを与え、ドアを閉めた静かな個室で寝てやり過ごさせる
- C水分摂取を制限する
- D振戦せん妄の可能性として扱い、緊急に医療的な助けを求め、処方に従ってベンゾジアゼピン系薬を投与し、安全を確保する
解答
- 1. D · Labile
- 2. B · Catastrophising
- 3. D · An idea of reference
- 4. C · New or worsening suicidal thoughts or unusual changes in mood or behaviour
- 5. A · It uses magnetic pulses on the scalp while the patient is awake, without causing a seizure
- 6. A · At the same time, on the same scale, in a gown, after emptying the bladder
- 7. A · パニックと決めつける前に、バイタルサインを含めて身体的にアセスメントし、方針に従って心電図を記録する
- 8. D · 振戦せん妄の可能性として扱い、緊急に医療的な助けを求め、処方に従ってベンゾジアゼピン系薬を投与し、安全を確保する
ステップごとの詳しい解答:このトピックは examproblems.com で練習できます。