1.やさしい
How does naltrexone help people with alcohol dependence?
- AIt causes vomiting and flushing if the person drinks alcohol
- BIt blocks opioid receptors and reduces the craving and pleasure from drinking
- CIt replaces alcohol in the brain and prevents withdrawal seizures
- DIt speeds up the breakdown of alcohol in the liver so that the person never feels drunk
2.やさしい
A patient is very dramatic, dresses to draw attention and is uncomfortable when she is not the centre of attention. Which personality disorder does this suggest?
- ASchizoid
- BParanoid
- CAvoidant
- DHistrionic
3.やさしい
What type of drug is methadone, used in the treatment of opioid dependence?
- AAn opioid antagonist that blocks all opioid effects
- BA long-acting full opioid agonist
- CA non-addictive stimulant that reduces opioid craving
- DA benzodiazepine that reduces anxiety during withdrawal
4.ふつう
A patient says, "The doctor says I'm getting better, but I don't think anyone here really knows me." Which nurse response is most therapeutic?
- A"Why do you think the doctor is wrong about you?"
- B"You feel that people here don't really know you?"
- C"The doctor is very experienced, so you should trust her."
- D"Everyone here knows you well, so don't worry."
5.ふつう
Which pattern suggests premenstrual dysphoric disorder?
- AMarked mood symptoms in the week before menstruation that improve within a few days after it starts
- BMood symptoms that begin only after the menopause and last for several years
- CMild bloating the day before a period, without any mood changes
- DLow mood throughout the whole month that is not linked to the menstrual cycle
6.ふつう
A woman was assaulted 10 days ago. She has nightmares, avoids the area and feels detached. According to DSM-5, which diagnosis fits the timing best?
- APost-traumatic stress disorder
- BAdjustment disorder with anxiety
- CGeneralised anxiety disorder
- DAcute stress disorder
7.むずかしい
任意入院の患者で、差し迫った危害のおそれがない人が、医学的助言に反して病棟を出たいと希望しています。正しい一般的な対応はどれですか？
- A医師の許可なく出ようとしたら、職員が拘束して病棟に連れ戻すと伝える
- Bリスクを説明し、チームに知らせ、話し合いを記録し、法律と方針に従って退院する権利を尊重する
- C患者の所持品を隠す
- D患者が出られないよう、ドアに鍵をかける
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
- B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
- C虫は現実ではないと説明し、休ませておく
- D水分摂取を制限する
解答
- 1. B · It blocks opioid receptors and reduces the craving and pleasure from drinking
- 2. D · Histrionic
- 3. B · A long-acting full opioid agonist
- 4. B · "You feel that people here don't really know you?"
- 5. A · Marked mood symptoms in the week before menstruation that improve within a few days after it starts
- 6. D · Acute stress disorder
- 7. B · リスクを説明し、チームに知らせ、話し合いを記録し、法律と方針に従って退院する権利を尊重する
- 8. B · 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
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