1.Perubatan-pembedahan: kardiovaskular & respiratoriSederhana
Seorang pesakit yang baru mengalami strok dan sukar menelan mengalami demam dan krepitasi di lobus bawah kanan. Apakah punca yang paling mungkin?
- AKegagalan ventrikel kiri
- BEmbolisme pulmonari
- CPneumonia aspirasi
- DAsma akut
2.Perubatan-pembedahan: kardiovaskular & respiratoriSukar
Why is the cuff pressure of an endotracheal or tracheostomy tube checked regularly?
- AThe cuff pressure directly controls the patient's oxygen saturation
- BToo high a pressure damages the trachea; too low allows aspiration
- CThe cuff pressure sets the ventilator's breathing rate
- DThe cuff must be kept fully deflated in every ventilated patient
3.Perubatan-pembedahan: neurologi, endokrin & renalSederhana
Why are patients on haemodialysis vaccinated against hepatitis B?
- AThe vaccine is needed to make the dialyser work
- BHepatitis B vaccine improves the fistula flow
- CThe vaccine lowers the potassium level
- DShared dialysis units carry a higher infection risk
4.Perubatan-pembedahan: neurologi, endokrin & renalSukar
A patient's potassium is 7.1 mmol/L, and the ECG shows peaked T waves and broad QRS complexes. What is the first treatment?
- AIV calcium gluconate
- BOral potassium binder
- CIV furosemide
- DOral sodium bicarbonate
5.Perubatan-pembedahan: GI, perioperatif & onkologiSederhana
Mengapakah urea mungkin meningkat jauh lebih banyak daripada kreatinin pada pesakit pendarahan GI atas?
- AUrea dihasilkan oleh lapisan perut yang berdarah
- BDarah yang dihadam ialah beban protein yang meningkatkan urea
- CPendarahan sentiasa merosakkan tubul buah pinggang secara langsung
- DKreatinin hilang daripada badan dalam muntah
6.Perubatan-pembedahan: GI, perioperatif & onkologiSukar
Using the adult rule of nines, what is the total burn area of the whole right arm plus the whole front of the trunk (both with partial-thickness burns)?
- A45%
- B27%
- C36%
- D18%
7.Kejururawatan klinikalSederhana
What should the nurse regularly check for a patient with a syringe driver?
- AOnly the patient's weight, measured once a week on the same scales
- BThe infusion site, the rate and volume remaining, and the patient's symptoms
- COnly that the battery is charged and the device is switched on
- DNothing, once the syringe driver is running
8.Kejururawatan klinikalSukar
Pesakit pada pam PCA opioid mempunyai kadar pernafasan 7/min dan sukar dikejutkan. Apakah yang patut dilakukan dahulu?
- ARekodkan pemerhatian dan semak semula pada pusingan empat jam seterusnya
- BTingkatkan dos bolus PCA kerana pesakit mungkin kesakitan
- CGalakkan pesakit menekan butang PCA lebih kerap untuk keselesaan
- DHentikan PCA, kejutkan pesakit, beri oksigen dan pastikan nalokson diberikan
9.Nilai makmal & elektrolitSederhana
After surgery for colon cancer, a patient's CEA had fallen to normal, but it has been rising over the last two checks. What does this most likely suggest?
- AA sure sign that the cancer has been fully cured
- BPossible recurrence that needs further assessment
- CA normal change after surgery that needs no follow-up
- DA sign of iron deficiency from the earlier bleeding
10.Nilai makmal & elektrolitSukar
A 68-year-old man has fatigue, a hemoglobin of 9.8 g/dL (98 g/L), an MCV of 72 fL and a low ferritin. He eats a normal diet. What is the most important next step?
- ALook for a source of blood loss in the gut
- BRepeat the blood count in one year
- CStart vitamin B12 injections
- DGive iron and do no further tests at all
11.Tafsiran gas darah arteriSederhana
Gas latihan menunjukkan PaCO₂ 25 mmHg (3.3 kPa). Gunakan peraturan bahawa dalam alkalosis respiratori akut HCO₃⁻ menurun 2 mmol/L bagi setiap 10 mmHg PaCO₂ di bawah 40, bermula dari HCO₃⁻ 24 mmol/L, untuk mencari HCO₃⁻ yang dijangka.
PaCO₂ 25 mmHg (3.3 kPa)garis asas: 40 mmHg, 24 mmol/L
HCO₃⁻ = mmol/L
12.Tafsiran gas darah arteriSukar
Pada aras laut, gas latihan yang diambil pada oksigen 50% menunjukkan PaO₂ 85 mmHg (11.3 kPa) dan PaCO₂ 42 mmHg (5.6 kPa). Gunakan PAO₂ = FiO₂·(760 − 47) − PaCO₂/0.8 untuk mencari Kecerunan A–a.
FiO₂ 50%PaO₂ 85 mmHg (11.3 kPa)PaCO₂ 42 mmHg (5.6 kPa)
Kecerunan A–a = mmHg
13.Tafsiran jalur rentak ECGSederhana
Ukur sela QT dan sela R–R pada jalur lead II yang teratur ini, kemudian kira QTc yang dibetulkan mengikut kadar dengan formula Bazett QTc = QT/√RR (kedua-duanya dalam saat). Berikan jawapan dalam saat kepada tiga tempat perpuluhan.
lead II, 25 mm/s, 10 mm/mV1 petak kecil = 0.04 s, 1 petak besar = 0.20 spanjang jalur 6 s
QTc = s
14.Tafsiran jalur rentak ECGSukar
Jalur lead II ini menunjukkan blok AV dengan rentak ventrikel yang tidak teratur. Gunakan kaedah 6 saat untuk mencari kadar ventrikel dalam denyut seminit.
lead II, 25 mm/s, 10 mm/mV1 petak kecil = 0.04 s, 1 petak besar = 0.20 spanjang jalur 6 s
kadar ventrikel = bpm
15.Pemberian keutamaan & delegasiSederhana
A nurse gives IV morphine for severe pain. When should the nurse reassess the pain and sedation?
- AOnly when the patient asks for more
- BAt the end of the shift
- CWithin about 15–30 minutes
- DAt the next routine round in four hours
16.Pemberian keutamaan & delegasiSukar
A patient is admitted with suspected meningococcal meningitis. Which precautions are needed until treatment has been given for long enough?
- ADroplet precautions
- BContact precautions only
- CStandard precautions only
- DAirborne precautions