정답이 있는 내외과: 심혈관계와 호흡기계 학습지

What causes the first heart sound (S1)?

1. AClosure of the aortic and pulmonary valves
2. BBlood flowing quickly into the atria
3. CThe heart muscle stretching in diastole
4. DClosure of the mitral and tricuspid valves

Which precautions are needed for a patient with suspected infectious pulmonary tuberculosis?

1. AContact precautions with gloves only
2. BAirborne precautions with a respirator mask
3. CProtective isolation for the patient's own sake
4. DStandard precautions only

What is the role of surfactant in the lungs?

1. AIt moves mucus up towards the throat
2. BIt kills bacteria that reach the alveoli from the air
3. CIt lowers surface tension so the alveoli stay open
4. DIt carries oxygen across the membrane into the blood

A patient with a mechanical heart valve asks to switch from warfarin to apixaban. What is the correct response?

1. AMechanical valves do not need anticoagulation after the first month
2. BAspirin alone can replace warfarin once the valve has healed
3. CDirect oral anticoagulants are not used for mechanical valves
4. DAny anticoagulant works equally well once the valve is in place

A patient on ramipril is to start sacubitril/valsartan for heart failure. What is the key safety point?

1. ASacubitril/valsartan is safe to start on the same morning
2. BThe ACE inhibitor dose should be doubled during the change
3. CBoth drugs should be taken together each day for the best effect
4. DThe ACE inhibitor must be stopped first, with a gap before starting

A patient is going home with a 24-hour Holter monitor. Which instruction is most important?

1. AStay in bed for the full 24 hours so the trace is clear
2. BShower as normal with the monitor on
3. CRemove the monitor whenever symptoms occur and restart it
4. DKeep a diary of symptoms and activities with the times

Why is the cuff pressure of an endotracheal or tracheostomy tube checked regularly?

1. AToo high a pressure damages the trachea; too low allows aspiration
2. BThe cuff pressure directly controls the patient's oxygen saturation
3. CThe cuff must be kept fully deflated in every ventilated patient
4. DThe cuff pressure sets the ventilator's breathing rate

Which instruction from the registered nurse to a healthcare assistant (unlicensed assistive personnel) caring for a patient with COPD is most appropriate?

1. A"Listen to his chest after lunch and let me know what you can hear."
2. B"Teach him how to use his new inhaler this afternoon after his rest."
3. C"Tell me straight away if his SpO₂ is under 88% or he is more breathless."
4. D"Turn his oxygen up to whatever he needs if he looks short of breath."