Hormati hak: pilihan yang paling kurang menyekat, persetujuan dan kerahsiaan beserta hadnya.
2Soalan latihan
1.Kejururawatan kesihatan mentalSederhana
Which group of signs suggests drug-induced pseudoparkinsonism in a patient taking haloperidol?
AShuffling gait, mask-like face, rigidity and a resting tremor
BRestless pacing and an inability to sit still
CLip smacking, tongue thrusting and grimacing after years of treatment
DSudden muscle spasm of the neck with the eyes rolled upwards
2.Kejururawatan kesihatan mentalSukar
An 80-year-old patient taking a benzodiazepine for sleep fell at night on the way to the toilet. After checking her for injury, what is the most appropriate next step?
ADo nothing more, because falls are normal in older people
BReport the fall, put falls precautions in place and ask for a review of her sleep medicine
CGive an extra dose so that she sleeps through the night without getting up
DUse bed rails and a restraint every night to keep her safely in bed until the morning
3.Psikologi klinikalSederhana
Pengaktifan tingkah laku merawat kemurungan terutamanya dengan:
AMeningkatkan penglibatan dalam aktiviti yang memberi ganjaran dan bernilai
BMenetapkan tempoh rehat sepenuhnya
CMeneroka konflik zaman kanak-kanak secara terperinci
DMendedahkan seseorang kepada sensasi badan yang ditakuti secara berperingkat
4.Psikologi klinikalSukar
Seorang askar mengalami PTSD manakala kebanyakan rakan seperjuangan yang terdedah kepada pertempuran yang sama tidak. Model manakah yang paling baik menerangkan perbezaan ini?
AModel ekonomi token
BModel perubatan jangkitan
CModel diatesis–tekanan
DModel kejarangan statistik
5.FarmakologiSederhana
Long-term use of metformin can cause a deficiency of which vitamin?
AVitamin B12
BVitamin D
CVitamin K
DVitamin A
6.FarmakologiSukar
Why may omeprazole be avoided in a patient taking clopidogrel?
AIt speeds up kidney excretion of clopidogrel
BIt inhibits CYP2C19, so less clopidogrel is converted to its active form
CIt binds clopidogrel in the stomach and makes it insoluble
DIt increases clopidogrel absorption from the gut and causes bleeding
3Larutan
1.Kejururawatan kesihatan mental
Jawapan: A · Shuffling gait, mask-like face, rigidity and a resting tremor
Mengapa ini jawapannya
Blocking dopamine in the nigrostriatal pathway can cause parkinsonian signs: bradykinesia, rigidity, tremor and a shuffling gait. The other options describe akathisia, acute dystonia and tardive dyskinesia.
Jawapan
A · Shuffling gait, mask-like face, rigidity and a resting tremor
2.Kejururawatan kesihatan mental
Jawapan: B · Report the fall, put falls precautions in place and ask for a review of her sleep medicine
Mengapa ini jawapannya
Benzodiazepines increase the risk of falls in older adults. After a fall, the nurse reports it, reduces risks such as poor lighting and the distance to the toilet, and asks for a medication review.
Jawapan
B · Report the fall, put falls precautions in place and ask for a review of her sleep medicine
3.Psikologi klinikal
Jawapan: A · Meningkatkan penglibatan dalam aktiviti yang memberi ganjaran dan bernilai
Mengapa ini jawapannya
Pengaktifan tingkah laku menjadualkan aktiviti yang mendatangkan keseronokan atau penguasaan, memutuskan kitaran penarikan diri dan peneguhan rendah. Ia rawatan berasaskan bukti untuk kemurungan.
Jawapan
A · Meningkatkan penglibatan dalam aktiviti yang memberi ganjaran dan bernilai
4.Psikologi klinikal
Jawapan: C · Model diatesis–tekanan
Mengapa ini jawapannya
Model diatesis–tekanan berpendapat bahawa penekan menyebabkan gangguan terutamanya pada orang yang mempunyai kerentanan sedia ada, seperti risiko genetik, trauma terdahulu atau sokongan sosial yang lemah.
Jawapan
C · Model diatesis–tekanan
5.Farmakologi
Jawapan: A · Vitamin B12
Mengapa ini jawapannya
Metformin reduces vitamin B12 absorption in the ileum. Deficiency can cause anaemia and neuropathy, so levels may be checked in long-term users.
Jawapan
A · Vitamin B12
6.Farmakologi
Jawapan: B · It inhibits CYP2C19, so less clopidogrel is converted to its active form
Mengapa ini jawapannya
Clopidogrel must be activated by liver enzymes, mainly CYP2C19. Omeprazole inhibits this enzyme and can reduce its antiplatelet effect, so another acid suppressant may be chosen.
Jawapan
B · It inhibits CYP2C19, so less clopidogrel is converted to its active form