Choroby wewnętrzne i chirurgiczne: przewód pokarmowy, okres okołooperacyjny i onkologia: karta pracy z odpowiedziami

How does the pain of acute appendicitis typically progress?

1. AIt starts in the right shoulder, then moves to the chest
2. BIt stays in the upper abdomen and eases after meals
3. CIt starts around the umbilicus, then moves to the right lower abdomen
4. DIt starts in the left lower abdomen, then spreads to the back

When should pain be reassessed after giving analgesia?

1. AOnly if the patient asks for more analgesia
2. BWhen the drug is expected to have taken effect
3. CNever, as one assessment is enough
4. DOnly at the next routine observation round the next day

What is the key difference between a benign and a malignant tumour?

1. AA benign tumour always grows faster than a malignant one
2. BA malignant tumour never needs any treatment
3. CA benign tumour always spreads to the lymph nodes
4. DA malignant tumour invades nearby tissue and can spread

Which advice may help reduce the risk of a parastomal hernia after stoma surgery?

1. AStrain hard on the toilet each day to strengthen the abdominal muscles
2. BAvoid heavy lifting early on and use support garments as advised
3. CKeep the stoma bag as full as possible
4. DDo intensive sit-ups from the first week

A patient with obstructive sleep apnoea is admitted for surgery. Which instruction is most appropriate?

1. ALie flat on their back for the first night
2. BBring their CPAP machine to use after surgery
3. CStop all pain relief for the first three days
4. DAvoid sleeping at all on the night after surgery

Why is the "whoosh" test no longer used to check nasogastric tube position?

1. AIt needs an X-ray machine at the bedside
2. BThe test is far too painful for most patients to tolerate
3. CThe air always makes the tube block
4. DAir can be heard even when the tube is in the lung

A surgical patient's MUST score is 3 and the wound is healing slowly. What is the most appropriate action?

1. AEncourage fasting to reduce wound exudate and the size of the dressing
2. BRestrict protein to help the kidneys
3. CRepeat the score in three months' time
4. DRefer to the dietitian, start a nutrition plan and monitor intake

A patient who takes NSAIDs suddenly develops severe epigastric pain, a rigid abdomen and shoulder-tip pain. Which finding would most support the likely diagnosis?

1. ATall, peaked T waves on a 12-lead ECG
2. BA raised serum lipase three times the upper limit
3. CFluid levels in the bladder on an ultrasound scan
4. DFree air under the diaphragm on an erect chest X-ray