Hormati hak: pilihan yang paling kurang menyekat, persetujuan dan kerahsiaan beserta hadnya.
2Soalan latihan
1.Kejururawatan kesihatan mentalSederhana
Which nursing action at mealtimes is most appropriate for a patient with anorexia nervosa?
AAllow the patient to choose to skip meals if she says she feels full or unwell
BLet the patient eat alone in her room for privacy
CTalk with the patient at length about calories during the meal
DSupervise the meal and observe the patient for an agreed period afterwards
2.Kejururawatan kesihatan mentalSukar
An 83-year-old becomes confused and constipated and cannot pass urine. She takes amitriptyline, oxybutynin and an over-the-counter sleep aid with diphenhydramine. What is the most likely cause?
AA sign that she needs a higher dose of amitriptyline
BThe combined anticholinergic effects of her medicines
CThe normal effects of ageing
DSudden-onset Alzheimer's disease
3.Psikologi klinikalSederhana
Klozapin lazimnya dikhaskan untuk skizofrenia tahan rawatan kerana:
AIa hanya berkesan pada gejala negatif
BIa antipsikotik yang paling kurang berkesan, jadi ia pilihan terakhir
CIa tidak boleh diambil sebagai tablet
DIa boleh menyebabkan agranulositosis, jadi pemantauan darah berkala diperlukan
4.Psikologi klinikalSukar
Seorang doktor mempertimbangkan sama ada pendekatan kategori atau dimensi terhadap gangguan personaliti lebih baik. Perkara manakah yang menyokong pendekatan dimensi?
AKategori terbukti memberikan kebolehpercayaan antara penilai yang sempurna
BSifat personaliti sama ada sepenuhnya hadir atau sepenuhnya tiada pada mana-mana seseorang
CModel dimensi tidak boleh diukur dengan soal selidik atau temu duga
DSifat berubah secara berterusan, dan kategori bertindih dengan had sempadan yang sewenang-wenangnya
5.FarmakologiSederhana
During an oxytocin infusion, contractions become very frequent and the fetal heart rate shows late decelerations. What is the nurse's first action?
AIncrease the infusion to finish labour quickly
BPosition the woman flat on her back
CGive a second oxytocin bolus
DStop the oxytocin infusion
6.FarmakologiSukar
In adult cardiac arrest with shock-refractory ventricular fibrillation, which antiarrhythmic is commonly given?
AVerapamil
BDigoxin
CAmiodarone
DAdenosine
3Larutan
1.Kejururawatan kesihatan mental
Jawapan: D · Supervise the meal and observe the patient for an agreed period afterwards
Mengapa ini jawapannya
Supervised meals and observation afterwards reduce hiding or discarding food, vomiting and excessive exercise. Mealtimes should be calm, with conversation that is not focused on food or weight.
Jawapan
D · Supervise the meal and observe the patient for an agreed period afterwards
2.Kejururawatan kesihatan mental
Jawapan: B · The combined anticholinergic effects of her medicines
Mengapa ini jawapannya
Several drugs with anticholinergic effects add up, increasing the risk of delirium, constipation and urinary retention in older adults. A medicine review aims to reduce the total anticholinergic burden.
Jawapan
B · The combined anticholinergic effects of her medicines
3.Psikologi klinikal
Jawapan: D · Ia boleh menyebabkan agranulositosis, jadi pemantauan darah berkala diperlukan
Mengapa ini jawapannya
Klozapin berkesan apabila antipsikotik lain gagal, tetapi ia boleh menyebabkan penurunan neutrofil yang berbahaya, jadi pesakit memerlukan ujian darah berkala.
Jawapan
D · Ia boleh menyebabkan agranulositosis, jadi pemantauan darah berkala diperlukan
4.Psikologi klinikal
Jawapan: D · Sifat berubah secara berterusan, dan kategori bertindih dengan had sempadan yang sewenang-wenangnya
Mengapa ini jawapannya
Diagnosis kategori bertindih secara besar-besaran dan menganggap kontinum sebagai ada/tiada. Seksyen III DSM-5 dan ICD-11 oleh itu menawarkan model dimensi gangguan personaliti berasaskan sifat.
Jawapan
D · Sifat berubah secara berterusan, dan kategori bertindih dengan had sempadan yang sewenang-wenangnya
5.Farmakologi
Jawapan: D · Stop the oxytocin infusion
Mengapa ini jawapannya
Excessive contractions reduce placental blood flow and cause fetal distress. The oxytocin is stopped first, then the woman is turned on her side, IV fluids and oxygen are given as per protocol and the provider is informed.
Jawapan
D · Stop the oxytocin infusion
6.Farmakologi
Jawapan: C · Amiodarone
Mengapa ini jawapannya
Amiodarone is used for VF or pulseless VT that persists after shocks, with lidocaine as an alternative. Adenosine, digoxin and verapamil have no role in VF.