1.Perubatan-pembedahan: kardiovaskular & respiratoriSederhana
A patient's blood pressure is high in clinic but normal on home readings. Which step best confirms the diagnosis?
- AA chest X-ray
- BStarting two antihypertensive drugs at once at full dose
- CAmbulatory or structured home blood pressure monitoring
- DA single repeat reading in the same clinic visit
2.Perubatan-pembedahan: kardiovaskular & respiratoriSukar
After a pneumonectomy, how is the patient usually positioned?
- AHead down with the legs raised, to drain secretions from the lung
- BFully on the non-operated side, to help drain the empty space
- CFlat and prone for the whole of the first day after surgery
- DOn the back or the operated side, not fully on the remaining lung
3.Perubatan-pembedahan: neurologi, endokrin & renalSederhana
Seorang pesakit AKI mempunyai kateter urin yang tidak mengalirkan apa-apa. Semakan pantas di sisi katil manakah yang membantu menyingkirkan punca pascarenal?
- AMenggalakkan pesakit minum dua liter air
- BMenghantar sampel air kencing untuk kultur dan menunggu keputusan makmal
- CMemeriksa kateter untuk lipatan atau sekatan dan melakukan imbasan pundi kencing
- DMemberikan bolus besar cecair IV serta-merta
4.Perubatan-pembedahan: neurologi, endokrin & renalSukar
A patient with untreated end-stage kidney disease has chest pain that is worse lying flat and better sitting forward. A rub is heard over the heart. What is most likely?
- AIndigestion from phosphate binders
- BA rib fracture from coughing
- CUraemic pericarditis, which usually needs urgent dialysis
- DA stable angina attack, which needs only a nitrate spray and rest
5.Perubatan-pembedahan: GI, perioperatif & onkologiSederhana
A patient on enteral feeding develops diarrhoea. What should the nurse review first?
- AThe patient's mobility aids and walking distance
- BThe colour of the feeding bag label
- CThe medicine chart, including laxatives and antibiotics
- DThe patient's eye drops and skin creams
6.Perubatan-pembedahan: GI, perioperatif & onkologiSukar
A patient with diabetes on continuous enteral feeding and an insulin regimen has the feed stopped for a procedure. What is the main concern?
- AHypoglycaemia if insulin continues without the feed
- BRefeeding syndrome from too much glucose
- CDiarrhoea from stopping the feed suddenly
- DHyperglycaemia because the stomach is empty
7.Kejururawatan klinikalSederhana
A patient is admitted with cellulitis of the leg. Why might the nurse mark the edge of the redness on the skin?
- ATo show the surgeon exactly where to make the incision
- BTo monitor whether the infection is spreading or improving
- CTo help the patient find the sore area
- DTo mark the site for an injection
8.Kejururawatan klinikalSukar
Why might a patient with diabetes who takes a beta-blocker not notice hypoglycaemia early?
- ABeta-blockers raise blood glucose, so true hypoglycaemia cannot happen at all
- BBeta-blockers can mask warning signs such as tremor and a fast heart rate
- CBeta-blockers stop the liver from responding to insulin
- DBeta-blockers make the patient sleep through the night
9.Nilai makmal & elektrolitSederhana
A patient with diabetes also takes propranolol. Why is regular glucose monitoring especially important?
- AThe drug stops the meter from reading correctly
- BThe drug causes very high glucose in all patients
- CThe drug can mask warning signs of hypoglycemia
- DThe drug blocks the insulin injection site
10.Nilai makmal & elektrolitSukar
Seorang pesakit yang mengambil apiksaban bertanya mengapa mereka tidak memerlukan ujian INR berkala seperti jiran mereka yang mengambil warfarin. Apakah penjelasan yang terbaik?
- AApiksaban sebenarnya tidak mencairkan darah
- BApiksaban dipantau dengan aPTT setiap hari sebaliknya
- CINR diperiksa secara rahsia bersama ujian darah rutin yang lain
- DKesannya boleh diramal, maka ujian pembekuan rutin tidak diperlukan
11.Tafsiran gas darah arteriSederhana
Gas latihan menunjukkan asidosis metabolik dengan HCO₃⁻ 6 mmol/L. Gunakan rumus Winter untuk mencari PaCO₂ yang dijangka (tengah julat) dalam mmHg.
HCO₃⁻ 6 mmol/L
PaCO₂ = mmHg
12.Tafsiran gas darah arteriSukar
Pada aras laut, gas latihan yang diambil pada oksigen 30% menunjukkan PaO₂ 84 mmHg (11.2 kPa) dan PaCO₂ 33 mmHg (4.4 kPa). Gunakan PAO₂ = FiO₂·(760 − 47) − PaCO₂/0.8 untuk mencari Kecerunan A–a.
FiO₂ 30%PaO₂ 84 mmHg (11.2 kPa)PaCO₂ 33 mmHg (4.4 kPa)
Kecerunan A–a = mmHg
13.Tafsiran jalur rentak ECGSederhana
Ukur Sela QT pada jalur lead II ini, dalam saat.
lead II, 25 mm/s, 10 mm/mV1 petak kecil = 0.04 s, 1 petak besar = 0.20 spanjang jalur 6 s
QT = 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 teaches a patient with COPD pursed-lip breathing. Which statement shows a need for further teaching?
- A“I will breathe in slowly through my nose.”
- B“I will breathe out slowly through pursed lips.”
- C“I will breathe in through my mouth and out quickly through my nose.”
- D“I will make my breath out about twice as long as my breath in.”
16.Pemberian keutamaan & delegasiSukar
A patient is going home on a new oral anticoagulant. There is only a short time for teaching. Which topic is most important?
- AWhich television programs help with relaxation
- BSigns of bleeding and when to seek help
- CHow to cook low-fat meals
- DHow to choose comfortable walking shoes