II 导联,25 mm/s,10 mm/mV1 个小格 = 0.04 s,1 个大格 = 0.20 s条带长度 6 s
QTc = s
12.心电图节律条带解读困难
识别这条 II 导联心电图上的节律。点击你的答案。
II 导联,25 mm/s,10 mm/mV1 个小格 = 0.04 s,1 个大格 = 0.20 s条带长度 6 s
1心脏停搏
2交界性心律
3心室颤动
4窦性心动过缓
13.优先排序与委派中等
A nurse teaches a patient about levothyroxine. Which statement shows a need for further teaching?
A“I will take it at breakfast with my calcium tablet.”
B“I will keep taking it even when I feel well.”
C“I will take it on an empty stomach with a glass of water.”
D“I will take it at the same time each morning.”
14.优先排序与委派困难
Two weeks after birth, a mother says she hears voices telling her the baby is evil. What is the priority?
AReassure her that this is normal “baby blues”
BLeave her alone with the baby to bond
CAdvise more sleep and book a routine follow-up visit for next month
DKeep the mother and baby safe and arrange urgent psychiatric care
15.感染控制与患者安全中等
A patient wants to use their own electric hair dryer in the hospital. What is correct?
AIt can be used in the bathroom near the sink if the patient is careful
BIt can be used straight away if it looks new
CIt is checked for electrical safety according to hospital policy before use
DIt can be plugged into an extension lead under the bed
16.感染控制与患者安全困难
A patient weighs 180 kg and needs to be moved from bed to chair. The standard ceiling lift on the unit has a lower weight limit. What should the nurse do?
AHave two staff lift the patient by hand
BAsk the patient to stand and pivot without help
CUse the standard lift, because limits include a safety margin
DUse bariatric-rated equipment and enough trained staff
17.实验室检查值与电解质中等
During a red cell transfusion, when are serious acute reactions most likely, so the nurse stays with the patient?
AThe next morning
BAfter the last drop is given
CIn the first 15 minutes
DAfter about 2 hours
18.实验室检查值与电解质困难
A 68-year-old man has fatigue, a hemoglobin of 9.8 g/dL (98 g/L), an MCV of 72 fL and a low ferritin. He eats a normal diet. What is the most important next step?
ARepeat the blood count in one year
BGive iron and do no further tests at all
CStart vitamin B12 injections
DLook for a source of blood loss in the gut
3溶液
1.护理学基础
答案: C · Lift the frame forward, then step into it
为什么是这个答案
The frame is lifted a short step forward with all four feet placed down, then the patient steps into it, usually leading with the weaker leg.
答案
C · Lift the frame forward, then step into it
2.护理学基础
答案: B · They may have neutropenic sepsis, which can quickly become fatal
为什么是这个答案
Patients with a low neutrophil count may have few signs of infection apart from fever and can deteriorate fast. Urgent assessment and IV antibiotics, usually within an hour, are needed.
答案
B · They may have neutropenic sepsis, which can quickly become fatal
3.临床护理
答案: C · Repositioning and distraction
为什么是这个答案
Positioning, heat or cold where safe, relaxation, distraction and explanation can all reduce pain alongside analgesics.
答案
C · Repositioning and distraction
4.临床护理
答案: B · A perforated peptic ulcer
为什么是这个答案
Sudden severe pain with a board-like abdomen suggests perforation and peritonitis. The patient needs nil by mouth, IV access, analgesia and urgent surgical review.
QT 与 QTc:QT 间期从 QRS 波群起点到 T 波终点。它随心率加快而缩短,因此要用以秒为单位的 R–R 间期按心率校正:Bazett QTc = QT/√RR,Fridericia QTc = QT/∛RR。多数教科书使用 Bazett 公式;它在心率快时校正过度,此时宜用 Fridericia。各参考标准的界限不同:QTc 男性高于约 0.45 s、女性高于约 0.46 s 通常称为延长,高于 0.50 s 称为明显延长。
测量
QT = 11 × 0.04 = 0.44 s
RR = 21 × 0.04 = 0.84 s
Bazett 公式
QTc = 0.44/√0.84 = 0.44/0.9165 = 0.48 s
答案
QTc = 0.48 s
超过男性(约 0.45 s)和女性(约 0.46 s)的通常上限:延长。(480 ms)
12.心电图节律条带解读
答案: 心脏停搏
室性节律:室性心动过速是连续三个或以上宽大(0.12 s 或以上)的波群,频率超过 100 次/分,通常为 150–250 次/分,节律规则,没有相关的 P 波。心室颤动是紊乱、不规则的波形,无法辨认 P 波、QRS 波群或 T 波,也没有可计数的频率。心脏停搏是几乎平直的线,没有心室活动;平直线一定要通过检查患者、导联和增益并换一个导联来确认。在复苏指南中,室颤和无脉性室速是可电击心律,心脏停搏则不是。
答案: A · “I will take it at breakfast with my calcium tablet.”
为什么是这个答案
Levothyroxine is best absorbed on an empty stomach and is separated from calcium and iron by several hours. It is usually lifelong, so it is not stopped when the patient feels better.
答案
A · “I will take it at breakfast with my calcium tablet.”
14.优先排序与委派
答案: D · Keep the mother and baby safe and arrange urgent psychiatric care
为什么是这个答案
Hallucinations and delusions after birth suggest postpartum psychosis, a psychiatric emergency with risk to mother and baby. Safety and urgent specialist care are the priorities.
答案
D · Keep the mother and baby safe and arrange urgent psychiatric care
15.感染控制与患者安全
答案: C · It is checked for electrical safety according to hospital policy before use
为什么是这个答案
Electrical items from home can be faulty and cause shocks or fires. Policies usually require them to be inspected before use, and extension cords near patients are avoided.
答案
C · It is checked for electrical safety according to hospital policy before use
16.感染控制与患者安全
答案: D · Use bariatric-rated equipment and enough trained staff
为什么是这个答案
Using equipment above its rated capacity can cause collapse and injury. Bariatric lifts, chairs and beds are used, with enough trained staff and a plan agreed in advance.
答案
D · Use bariatric-rated equipment and enough trained staff
17.实验室检查值与电解质
答案: C · In the first 15 minutes
为什么是这个答案
Acute hemolytic and anaphylactic reactions usually appear early, so the transfusion is started slowly and the nurse stays with the patient for about the first 15 minutes, checking vital signs before, during and after according to policy.
答案
C · In the first 15 minutes
18.实验室检查值与电解质
答案: D · Look for a source of blood loss in the gut
为什么是这个答案
Iron deficiency in an older man or a postmenopausal woman suggests chronic blood loss, often from the gastrointestinal tract, including colorectal cancer. Iron is started, but endoscopy or colonoscopy is needed to find the cause.