1.やさしい
Which group of features is typical of dementia with Lewy bodies?
- ASudden step-by-step decline after small strokes
- BFluctuating alertness, detailed visual hallucinations and parkinsonism
- CMemory loss only, with no other symptoms or changes in alertness for many years
- DEarly personality change and loss of social inhibition
2.やさしい
A patient stops speaking in the middle of a sentence and cannot remember what he was saying. What is this called?
- AFlight of ideas
- BThought blocking
- CWord salad
- DClang association
3.やさしい
For which patients is clozapine mainly used?
- APatients having their very first episode of mild psychosis
- BPatients with schizophrenia that has not responded to two other antipsychotics
- COlder patients with dementia who become agitated and restless in the evening
- DPatients with mild anxiety who need a short-term sedative
4.ふつう
Which nurse statement is most consistent with motivational interviewing?
- A"If you don't stop drinking now, you'll die."
- B"You're an alcoholic, and you need to admit it."
- C"What would be different for you if you drank less?"
- D"I've decided that you need to stop drinking completely."
5.ふつう
How may depression present differently in adolescents than in adults?
- AWith increased energy and less need for sleep
- BWith irritability rather than obvious sadness
- CAlways with psychotic symptoms
- DWith a high fever and a rash
6.ふつう
双極性障害でラモトリギンを服用している患者に、新たに発疹が出ました。看護師はどうすべきですか?
- A重い皮膚反応の始まりかもしれないため、速やかに報告する
- B発疹は常に無害なので、無視する
- C発疹はよくあるので、保湿剤を塗り、薬は通常どおり続ける
- D用量を 2 倍にする
7.むずかしい
An 83-year-old becomes confused and constipated and cannot pass urine. She takes amitriptyline, oxybutynin and an over-the-counter sleep aid with diphenhydramine. What is the most likely cause?
- AThe normal effects of ageing
- BSudden-onset Alzheimer's disease
- CA sign that she needs a higher dose of amitriptyline
- DThe combined anticholinergic effects of her medicines
8.むずかしい
何週間も重いうつ状態にあった患者が、突然明るく穏やかになり、腕時計を別の患者にあげました。最も適切な対応はどれですか?
- A気分が明らかに改善していると考え、観察のレベルを下げる
- B明日の退院を計画する
- C自殺念慮と計画について直接尋ね、チームに知らせる
- D気前のよさをほめ、ほかには何も言わない
解答
- 1. B · Fluctuating alertness, detailed visual hallucinations and parkinsonism
- 2. B · Thought blocking
- 3. B · Patients with schizophrenia that has not responded to two other antipsychotics
- 4. C · "What would be different for you if you drank less?"
- 5. B · With irritability rather than obvious sadness
- 6. A · 重い皮膚反応の始まりかもしれないため、速やかに報告する
- 7. D · The combined anticholinergic effects of her medicines
- 8. C · 自殺念慮と計画について直接尋ね、チームに知らせる
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