정답이 있는 내외과: 신경계, 내분비계, 신장 학습지

What is a positive Kernig's sign?

1. APain and resistance when the knee is straightened with the hip flexed
2. BTwitching of the facial muscles when the cheek is tapped in front of the ear
3. CBending of the hips and knees when the neck is flexed
4. DBruising behind the ear after a head injury

How do sulfonylureas such as gliclazide lower blood glucose?

1. AThey make the kidneys pass more glucose
2. BThey replace insulin that the body lacks
3. CThey make the pancreas release more insulin
4. DThey slow down the absorption of food

What is diabetic gastroparesis?

1. AInflammation of the pancreas from high glucose
2. BSlow emptying of the stomach due to nerve damage
3. CA stomach ulcer caused by long-term metformin use
4. DA blockage of the small bowel by scar tissue

A patient with type 1 diabetes has gastroenteritis and cannot eat. Which sick-day advice is correct?

1. ACheck glucose once a day only and rest in bed until better
2. BKeep taking basal insulin and check glucose and ketones more often
3. CAvoid drinking fluids to reduce the vomiting
4. DStop all insulin until normal eating restarts

Which approach helps most when talking to a patient with expressive aphasia?

1. AAvoid talking to them until their speech has recovered
2. BAsk questions that can be answered with yes, no or a gesture
3. CSpeak louder, because the patient cannot hear well
4. DFinish their sentences quickly to save them effort

A patient has just started levetiracetam. Which side effect should the nurse teach them to report?

1. AOrange discoloration of the urine
2. BA persistent dry cough at night
3. CSwelling and overgrowth of the gums around the teeth
4. DChanges in mood, such as irritability, low mood or anger

Why may nitrofurantoin be avoided in an older patient with significantly reduced kidney function?

1. AIt cannot be taken with food in kidney disease
2. BIt turns the urine red in kidney disease
3. CIt works less well and is more likely to be toxic
4. DIt cures kidney disease too quickly

A patient with an insulin pump is admitted with nausea, a glucose of 19 mmol/L (342 mg/dL) and blood ketones of 3.1 mmol/L. What is the priority?

1. ADisconnect the pump and give no insulin until the ketones clear
2. BIncrease the pump rate and recheck the ketones in 12 hours
3. CSuspect failed insulin delivery and give insulin by another route
4. DGive an antiemetic only, because nausea is causing the high glucose