Hormati hak: pilihan yang paling kurang menyekat, persetujuan dan kerahsiaan beserta hadnya.
2Soalan latihan
1.Kejururawatan kesihatan mentalSederhana
A patient taking valproate is starting lamotrigine. Why must lamotrigine be increased especially slowly?
AValproate makes lamotrigine work faster, so the dose must be increased quickly
BValproate raises lamotrigine levels, which increases the risk of a serious rash
CThe two drugs together cause severe hair growth
DLamotrigine will lower the valproate level until it has no effect
2.Kejururawatan kesihatan mentalSukar
A man with gambling disorder has lost his savings and has large debts. He tells the nurse, "My family would be better off without me." What should the nurse do?
AChange the subject to his gambling triggers and how to avoid the betting shop
BAsk directly about suicidal thoughts and plans, and assess his risk
CFocus only on helping him create a budget
DReassure him that his family will forgive him
3.Psikologi klinikalSederhana
Seorang klien berkata "Saya gagal satu ujian, jadi saya akan gagal dalam segala-galanya." Herotan kognitif manakah ini?
AMembaca fikiran
BPengitlakan berlebihan
CPenaakulan emosi
DPempersonalan
4.Psikologi klinikalSukar
Penemuan otak manakah yang berulang kali dilaporkan dalam kumpulan orang dengan skizofrenia berbanding kawalan?
AVentrikel lateral yang membesar
BKetiadaan hipokampus sepenuhnya
CLobus frontal yang membesar pada semua pesakit
DTumor dalam kelenjar pituitari
5.FarmakologiSederhana
Satu ubat merencat enzim hati CYP3A4. Apakah yang boleh berlaku pada ubat kedua yang terutamanya dimetabolismekan oleh CYP3A4?
ATiada apa-apa, kerana enzim tidak menjejaskan ubat lain
BParas plasmanya jatuh, jadi ia mungkin berhenti berfungsi pada dos biasa
CIa dirembeskan lebih cepat oleh buah pinggang
DParas plasmanya meningkat, menambah risiko kesan sampingan
6.FarmakologiSukar
A noradrenaline infusion is running through a peripheral cannula. The skin around the site becomes pale, cold and hard. What should the nurse do?
ALeave the infusion running and recheck in 4 hours
BIncrease the rate to improve blood flow to the area
CApply heat and massage the area, then continue the infusion
DStop the infusion at that site and follow the extravasation protocol
3Larutan
1.Kejururawatan kesihatan mental
Jawapan: B · Valproate raises lamotrigine levels, which increases the risk of a serious rash
Mengapa ini jawapannya
Valproate inhibits the metabolism of lamotrigine, roughly doubling its levels. Because lamotrigine rash, including Stevens-Johnson syndrome, is linked to rapid dose increases, a slower titration is used.
Jawapan
B · Valproate raises lamotrigine levels, which increases the risk of a serious rash
2.Kejururawatan kesihatan mental
Jawapan: B · Ask directly about suicidal thoughts and plans, and assess his risk
Mengapa ini jawapannya
Gambling disorder is associated with a raised risk of suicide, especially with debt, shame and hopelessness. The statement is a warning sign that needs direct questions and risk assessment.
Jawapan
B · Ask directly about suicidal thoughts and plans, and assess his risk
3.Psikologi klinikal
Jawapan: B · Pengitlakan berlebihan
Mengapa ini jawapannya
Pengitlakan berlebihan membuat kesimpulan menyeluruh daripada satu peristiwa. Terapi kognitif Beck mengajar klien memerhati dan menguji herotan sedemikian.
Jawapan
B · Pengitlakan berlebihan
4.Psikologi klinikal
Jawapan: A · Ventrikel lateral yang membesar
Mengapa ini jawapannya
Ventrikel yang membesar dan jirim kelabu yang berkurang ditemui secara purata dalam skizofrenia. Perbezaan ini ialah purata kumpulan dan tidak bersifat diagnostik bagi individu.
Jawapan
A · Ventrikel lateral yang membesar
5.Farmakologi
Jawapan: D · Paras plasmanya meningkat, menambah risiko kesan sampingan
Mengapa ini jawapannya
Perencat enzim (contohnya klaritromisin atau jus limau gedang untuk CYP3A4) memperlahankan metabolisme, maka ubat kedua terkumpul. Pendorong enzim mempunyai kesan sebaliknya.
Jawapan
D · Paras plasmanya meningkat, menambah risiko kesan sampingan
6.Farmakologi
Jawapan: D · Stop the infusion at that site and follow the extravasation protocol
Mengapa ini jawapannya
Extravasation of a vasopressor can cause tissue necrosis. The infusion is stopped and moved to another site, and phentolamine, an alpha blocker, may be injected into the area to reverse vasoconstriction.
Jawapan
D · Stop the infusion at that site and follow the extravasation protocol