1.Perubatan-pembedahan: kardiovaskular & respiratoriSederhana
A patient has a heart rate of 36/min with hypotension and dizziness. Which drug is usually the first choice?
- AIntravenous atropine
- BIntravenous adenosine
- CIntravenous amiodarone
- DOral bisoprolol
2.Perubatan-pembedahan: kardiovaskular & respiratoriSukar
After chest trauma, a patient is hypotensive with reduced breath sounds on the left. Which finding suggests a haemothorax rather than a tension pneumothorax?
- ADistended neck veins
- BHyper-resonance on the affected side
- CTrachea pushed away from the affected side
- DDullness to percussion on the affected side
3.Perubatan-pembedahan: neurologi, endokrin & renalSederhana
A patient with untreated hyperthyroidism is losing weight. Which diet is most appropriate until the condition is controlled?
- AA strict low-protein diet
- BA low-calorie diet to protect the heart
- CA diet very high in caffeine for energy
- DA high-calorie diet with enough protein
4.Perubatan-pembedahan: neurologi, endokrin & renalSukar
Which patient on a stroke unit is most at risk of falling?
- AA patient with a TIA whose symptoms resolved completely yesterday
- BA patient with a right-hemisphere stroke who is impulsive and denies having weakness
- CA patient with a left-hemisphere stroke who has expressive aphasia and waits for help
- DA patient with mild dysarthria who walks steadily with a frame
5.Perubatan-pembedahan: GI, perioperatif & onkologiSederhana
Which is a recognised cause of anaphylaxis during surgery?
- AA warmed blanket
- BChlorhexidine skin preparation
- CSterile normal saline
- DThe patient's own blood from cell salvage
6.Perubatan-pembedahan: GI, perioperatif & onkologiSukar
Seorang berumur 74 tahun dengan penyakit buah pinggang kronik mengalami kesakitan teruk selepas pembedahan. Isu opioid manakah yang paling penting?
- AFungsi buah pinggang tidak memberi kesan terhadap cara opioid dikendalikan
- BMetabolit morfin terkumpul, jadi dos yang lebih rendah atau opioid lain mungkin diperlukan
- COpioid tidak boleh sekali-kali digunakan pada warga emas, apa pun kesakitannya
- DMorfin ialah opioid paling selamat dalam kegagalan buah pinggang, jadi dos boleh dinaikkan dengan bebas
7.Kejururawatan klinikalSederhana
Pemerhatian manakah yang paling penting selepas memberi pesakit dos pertama antibiotik baharu secara intravena?
- ASeleranya pada hidangan seterusnya
- BBerapa banyak dia berjalan pada hari itu
- CSama ada keguguran rambutnya bertambah
- DTanda tindak balas alahan seperti ruam, berdehit atau bengkak
8.Kejururawatan klinikalSukar
A patient has sudden, severe "tearing" chest pain going through to the back and a large difference in blood pressure between the arms. What should be suspected?
- AStable angina
- BGastro-oesophageal reflux
- CPericarditis
- DAortic dissection
9.Nilai makmal & elektrolitSederhana
When do the blood counts usually reach their lowest point (nadir) after many standard chemotherapy regimens?
- AOn the same day as treatment
- BWithin 1–2 hours of treatment
- CAbout 6 months after treatment
- DAbout 7–14 days after treatment
10.Nilai makmal & elektrolitSukar
A young adult has fatigue, bruising and fever. The white cell count is 85 × 10³/µL with many blasts, the hemoglobin is 7.9 g/dL (79 g/L) and the platelets are 22 × 10³/µL. What is the most likely diagnosis?
- AAcute viral infection
- BAcute leukemia
- CPolycythemia vera
- DIron-deficiency anemia
11.Tafsiran gas darah arteriSederhana
Gas latihan menunjukkan PaCO₂ 27 mmHg (3.6 kPa). Gunakan peraturan bahawa dalam alkalosis respiratori kronik HCO₃⁻ menurun 5 mmol/L bagi setiap 10 mmHg PaCO₂ di bawah 40, bermula dari HCO₃⁻ 24 mmol/L, untuk mencari HCO₃⁻ yang dijangka.
PaCO₂ 27 mmHg (3.6 kPa)garis asas: 40 mmHg, 24 mmol/L
HCO₃⁻ = mmol/L
12.Tafsiran gas darah arteriSukar
Gas latihan menunjukkan alkalosis metabolik dengan HCO₃⁻ 39 mmol/L. Gunakan PaCO₂ yang dijangka = 0.7·HCO₃⁻ + 21 untuk mencari PaCO₂ yang dijangka.
HCO₃⁻ 39 mmol/L
PaCO₂ = 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 darjah kedua jenis I (Wenckebach). Ukur sela PR bagi denyutan terakhir yang dikonduksikan sebelum gelombang P yang tidak dikonduksikan (PR terpanjang), dalam saat.
lead II, 25 mm/s, 10 mm/mV1 petak kecil = 0.04 s, 1 petak besar = 0.20 spanjang jalur 6 s
PR terpanjang = s
15.Pemberian keutamaan & delegasiSederhana
A patient is receiving a blood transfusion. Which task can the nurse delegate to a nursing assistant?
- AAssessing the patient for signs of a transfusion reaction
- BDeciding whether to stop the transfusion if the patient has chills
- CMeasuring and reporting vital signs at the times set by the nurse
- DStarting the transfusion once the blood arrives
16.Pemberian keutamaan & delegasiSukar
A patient was knocked out briefly in a fall, then woke and talked normally. Two hours later the patient becomes drowsy and one pupil is larger. What is the most likely cause?
- ANormal tiredness after a fall
- BAn epidural hematoma
- CA mild concussion that is settling
- DLow blood sugar from missing a meal